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Biomedical subjects

M M Stevens

Publications and source records attributed to M M Stevens.

At least 19 recordsLinked to original sources
PubMed2004

Factors affecting the toxicity of Bacillus thuringiensis var. israelensis and Bacillus sphaericus to fourth instar larvae of Chironomus tepperi (Diptera: Chironomidae).

Laboratory bioassays (48h duration, 25+/-1 degrees C) were used to determine the toxicity of Bacillus thuringiensis var. israelensis (B.t.i.) and Bacillus sphaericus to fourth instar larvae of Chironomus tepperi, a major pest of rice in southern Australia. Bioassays were conducted using different combinations of larval ages and densities to determine if these factors affected toxicity. The effects of temperature and substrate type on B.t.i. toxicity were also investigated. Tests were conducted using a commercial B.t.i. formulation (VectoBac WDG, 3000ITU/mg), a spore/crystal mixture derived from the VectoBac WDG strain, and VectoLex WDG, a commercial B. sphaericus formulation (650ITU/mg). VectoBac WDG was highly toxic to fourth instar C. tepperi in bioassays using a sand substrate (LC(50) 0.46mg/L, older larvae); younger fourth instar larvae were more susceptible (LC(50) 0.20mg/L). Increasing larval densities (from 10 to 30 per bioassay cup) increased LC(50) values for both age groups, significantly so in the case of older larvae (higher density LC(50) 0.80mg/L). Use of a soil substrate increased the LC(50) value (older larvae, 10 per cup) to 0.99mg/L. Similar differences in toxicity relative to larval age and substrate type were found in bioassays using the B.t.i. spore/crystal mixture. VectoBac WDG and the spore/crystal mixture both showed similar (approximately 6-fold) declines in activity between 30 and 17.5 degrees C. At lower temperatures (between 17.5 and 15 degrees C), activity of the spore/crystal mixture declined much more rapidly than that of VectoBac WDG. VectoLex WDG showed very low toxicity to C. tepperi larvae, and the overall impact of larval age and density was relatively minor (LC(50) values 1062-1340mg/L). Autoclaving VectoLex WDG did not substantially reduce its toxicity (LC(50) 1426mg/L), suggesting that formulation additives (i.e., surfactants and other adjuvants) are responsible for much of the toxicity occurring at the high product concentrations required to cause C. tepperi mortality. Whilst VectoLex WDG was ineffective against C. tepperi, VectoBac WDG has the potential to provide selective control of this rice pest at economically viable application rates.

Animals↗
PubMed2003

Oviposition response of Chironomus tepperi to nitrogenous compounds and bioextracts in two-choice laboratory tests.

Two-choice laboratory tests were used to investigate the oviposition response of Chironomus tepperi to a range of nitrogenous compounds and crude bioextracts. Responses to nitrogenous compounds varied in response to concentration. Ammonium nitrate did not influence oviposition at concentrations from 2 to 12 mg/liter. Hydroxylamine hydrochloride increased oviposition at 6 mg/liter, but had no effect at either 2 or 12 mg/liter. Sodium nitrate reduced oviposition at 2 mg/liter relative to the controls, but had no significant effect at 6 or 12 mg/liter. C. tepperi responded to many of the crude bioextracts, strongly avoiding oviposition in solutions containing homogenized chironomid larvae ( 1 final instar/100 ml; C. tepperi or Polypedilum nubiferum), and avoiding solutions conditioned by conspecific larvae at concentrations down to the equivalent of 1 final instar/100 ml over 24 hr. Homogenates of adult conspecifics had no effect on oviposition site selection. Homogenates of larval Culex annulirostris (Culicidae) deterred oviposition, but only at high concentrations (3 final instars/100 ml). Our results demonstrate that chemical cues from larval populations deter oviposition by C. tepperi females searching for newly flooded habitats where larval competition will be minimized.

Animals↗
PubMed2002

The measurement of symptoms in young children with cancer: the validation of the Memorial Symptom Assessment Scale in children aged 7-12.

Few studies have attempted to describe the experience of symptoms in young children with cancer. This is due, in part, to the lack of validated symptom assessment scales for this patient population. The objective of this study was to evaluate the reliability and validity of a revised Memorial Symptom Assessment Scale (MSAS) in patients aged 7-12 as an instrument for the assessment of symptoms in young children with cancer. The MSAS (7-12) was administered to 149 children (inpatients and outpatients) who were undergoing treatment at either the Royal Marsden NHS Trust, London, United Kingdom or The Children's Hospital at Westmead, Sydney, Australia. Validity was evaluated by comparison with the medical record, parental report, and concurrent assessment on visual analogue scales for selected symptoms. The data provide evidence of the reliability and validity of MSAS (7-12) and demonstrate that children with cancer as young as 7 years can report clinically relevant and consistent information about their symptom experience. Young children with cancer experience multiple symptoms. Approximately one-third had experienced lethargy and/or pain and/or insomnia during the 48 hours prior to the completion of MSAS (7-12). The completion rate for MSAS (7-12) was high and the majority of children completed the instrument in a short period of time and with little difficulty. The instrument appears to be age appropriate and may be helpful to older children unable to independently complete MSAS (10-18). Systematic symptom assessment may be useful in future epidemiological studies of symptoms and in cancer chemotherapy drug trials.

Child↗
PubMed2002

Comparison of two bioassay techniques for assessing the acute toxicity of pesticides to chironomid larvae (Diptera: Chironomidae).

Two container and substrate combinations were compared to determine which provided optimal survival of larvae of Chironomus tepperi and Glyptotendipes paripes in the absence of toxicants. Unfed final-stage larvae of G. paripes survived significantly (P < 0.05) better in waxed paper cups with sand substrate (92.8% after 3 days) than in glass tubes with a shredded paper substrate (85.3%). Survival of larvae of C. tepperi over the same period did not differ significantly in the 2 systems. Larvae of C. tepperi were bioassayed against 3 insecticides (technical and formulated imidacloprid, chlorpyrifos, and betacypermethrin) with both container and substrate combinations. Median lethal concentration values (24 h) obtained with waxed cups with sand were 1.8 times higher on average than those obtained with glass tubes with shredded paper (range 1.13-2.65 times). To determine the cause of this variability, solid-phase microextraction was used to measure changes in chlorpyrifos availability over time in the 2 bioassay systems. Chlorpyrifos concentrations in the waxed cups and sand system fell from 7.50 to 3.36 microg/liter over 24 h, probably as a consequence of chemical adsorption to the waxed surfaces. Chlorpyrifos concentrations in the glass tubes and paper system remained unchanged over this period. Excluding substrates from the containers had only a minor effect on chlorpyrifos availability. These results demonstrate that the behaviors of both test organisms and toxicants within bioassay systems need to be understood if the data generated with different systems are to be compared. Understanding how toxicant availability is affected by different container and substrate types is particularly important where bioassays are conducted with nominal concentration values rather than analytically determined exposure concentrations.

Animals↗
PubMed2001

Children and guns in a well child cohort.

BACKGROUND: The purpose of this study was to estimate the extent of and to identify predictors of preadolescent gun use in a well child cohort with matched parent and child data. METHODS: We analyzed self-report questionnaires from children and their parents using conditional logistic regression models. Questionnaires were given to 3,145 ten- to twelve-year-old children and 3,145 parents enrolled by their pediatricians in a prevention cohort study. RESULTS: Thirty-two percent of the children lived in households with guns. Children and parents generally agreed about the presence of guns in their homes; 17% had access to unlocked guns in their homes; 22% had fired guns. In this preadolescent cohort, firing guns was associated with being male, having guns in the home, having friends who use guns, and initiation of alcohol use. CONCLUSIONS: In this well child cohort, significant numbers of preadolescent, healthy boys in white, middle-class U.S. homes have access to guns, are using guns, and have friends who use guns. These children are also early alcohol adopters. Safety interventions with parents of preadolescents about the risks for accidental injury, death, and suicide due to child gun use may prove beneficial.

Alcohol Drinking↗
PubMed2001

Laboratory and field studies on the effect of molinate, clomazone, and thiobencarb on nontarget aquatic invertebrates.

The midge Chironomus tepperi was used in laboratory experiments to assess the relative toxicity of formulated molinate, clomazone, and thiobencarb, three herbicides used in Australian rice crops. Static bioassays were initiated with first-instar larvae at herbicide concentrations between 0.0625 and 2 times the anticipated field concentrations (AFCs) expected from the registered application rates. Adult emergence success, development time, and wing length were used as indices of the effect of each herbicide. Clomazone had no effect on any parameters at concentrations up to 0.288 mg/L (p > 0.05). Molinate significantly increased development time at concentrations equivalent to the AFC (3.6 mg/L) and above (p < 0.05). Thiobencarb reduced emergence success of adult C. tepperi at 0.0625 times the AFC (0.1875 mg/L) as well as decreasing male adult size and increasing development time for males and females at 0.125 times the AFC (p < 0.05). Nontarget effects of the herbicides on aquatic invertebrate communities were assessed in shallow experimental ponds using commercial application rates. One week after treatment, only thiobencarb had a significant effect, suppressing populations of chironomids, calanoids, and cyclopoids (p < 0.05). Four weeks later, all populations had recovered, equaling or exceeding control densities.

Animals↗
PubMed2000

E-mail communication between medical students and schoolchildren: A model for medical education.

OBJECTIVE: To examine e-mail communication between student physicians and schoolchildren, in the context of a school-based tobacco prevention program, as a way to teach communication skills and model physician-patient interactions. DESIGN: Twenty medical students and pediatric residents were partnered with groups of children as part of HealthQuest, a tobacco prevention program implemented in 2 kindergarten through grade 12 Vermont schools. Medical students and residents acted as mentors for their group and provided support to the schoolchildren through e-mail and occasional site visits. E-mail messages were transmitted and stored in a Web server and monitored by preceptors. Content analysis of the messages was performed to identify emerging themes. RESULTS: During the 2-year intervention period, 1187 messages were exchanged between children, teachers, and the student physicians. Thirty-two percent (n = 383) of the messages involved tobacco, of which 54% addressed health effects; 23% were related to social influences of tobacco use, 15% to cessation by parents and others, and 7% to cessation by students. Other categories included nontobacco health issues (n = 135), personal questions (n = 294), and classroom information (n = 735). Many inquiries required medical students and residents to research their answers, and several required collaboration with preceptors, because the questions raised serious medical or psychosocial issues. With feedback, medical students and residents adjusted their responses so that they were appropriate for the developmental level of the children. CONCLUSIONS: The e-mail component of this program provided important learning opportunities for student physicians in tobacco control, child development, communication skills, and developing a physician-patient relationship. This model also offers potential benefits for medically underserved pediatric populations. Arch Pediatr Adolesc Med. 2000;154:1258-1262.

Child↗
PubMed2000

Acute and chronic toxicity of the herbicide benzofenap (Taipan 300) to Chironomus tepperi Skuse (Diptera: Chironomidae) and Isidorella newcombi (Adams and Angas) (Gastropoda: Planorbidae).

Acute and chronic toxicity tests were conducted on the herbicide benzofenap (Taipan 300) using two Australian freshwater invertebrates. The commercial formulation of benzofenap and a blank formulation containing only the adjuvants of Taipan 300 were tested against final instar larvae of the midge Chironomus tepperi and adults of the aquatic snail Isidorella newcombi. In 24-h acute bioassays the midge larvae did not show significant mortality at a nominal concentration of 1.2 mg/L active ingredient (AI), double the maximum notional concentration expected in rice fields after application of Taipan 300 at the permit rate of 2 L/ha. No significant snail mortality was recorded in acute bioassays (24-h exposure, 48-h recovery) at nominal concentrations up to 76 mg/L AI, which is over 120 times the maximum notional field concentration. In chronic assays, the pupation and emergence of C. tepperi was monitored after a 4-h pulse exposure of final instar larvae to Taipan 300 (nominal concentrations 0.001 to 0.1 mg/L AI) and adjuvant-only (0.1 mg/L equivalent) treatments. No statistically significant effects were observed, although emergence appeared to be delayed by higher benzofenap concentrations and by the adjuvant-only treatment. During snail bioassays, egg and feces production were monitored for 21 days after 24-h exposure to Taipan 300 (nominal concentrations 1.2 mg/L to 60 mg/L AI) and adjuvant-only treatments (60 mg/L equivalent). No significant chronic effects were proven against I. newcombi, despite a decline in egg mass production following exposure to all treatments and a reduction in the total numbers of eggs produced at the highest nominal concentrations tested (60 mg/L AI and adjuvant-only treatments). Similarly, feces production by snail pairs exposed to the majority of treatments declined, but these differences were not statistically significant. It is concluded that Taipan 300 does not represent a significant risk to mature C. tepperi larvae or adult I. newcombi in downstream environments when applied to rice fields at the permit rate of 2 L/ha.

Acetophenones↗
PubMed2000

Mammography in New Hampshire: characteristics of the women and the exams they receive.

New Hampshire (NH) is one of two states that has developed a population-based mammography registry. The purpose of this paper is to describe what we have learned about mammography use in New Hampshire. After collecting data for 20 months, the database contains almost 110,000 mammographic encounters representing 101,679 NH women, who range in age from 18 to 97 with a mean of 56.7 years (SD=10.91). Education levels are high with 92% having a high school education and 59% with some college. Forty-six percent report their primary insurance is private, 29% report HMO/PPO coverage, and 25% receive federal health care assistance. Risk factors represented in the database include (categories not mutually exclusive) advancing age (60% over age 50), hormone replacement therapy use by menopausal women (40.6%), and a family history of breast cancer (29%). Penetration of mammography relative to the NH population is higher for younger age groups (40-48% for those aged 44-64) than older age groups (34-39% for those aged 65-84). The majority of mammographic encounters are routine screening exams (86%), often interpreted as negative or normal with benign findings (88%). Use of comparison films to interpret either diagnostic or screening mammography occurred in 86% of encounters. We have matched 3,877 breast pathology records to these mammographic encounters. The distribution of pathology outcomes for diagnostic exams was very similar to that for screening exams (approximately 65% benign, 17% invasive breast cancer, and 6% noninvasive breast cancer). Overall, we have designed a system that is well accepted by the NH community. Challenges include careful monitoring of data for coding errors, and a limitation of linking variables in mammography and pathology data. Data represented in this registry are a critical resource for research in mammographic screening and breast cancer early detection.

Adolescent↗
PubMed2000

Probing protein-peptide-protein molecular architecture by atomic force microscopy and surface plasmon resonance.

We demonstrate the creation of a protein multilayer which utilises the high affinity interaction between streptavidin and biotin and incorporates a peptidic spacer. Surface plasmon resonance measurements enabled us to monitor the construction of the multilayer in real time. Atomic force microscopy was utilised to determine surface functionality at each stage of the multilayer construction, allowing us to investigate the associated mechanical properties. In this context we observed an increase in biomolecular stretching on the formation of the multilayer. We demonstrate, utilising circular dichroism, that variations in the solvent can affect the secondary structure of the peptide linker and hence its mechanical properties. Trifluoroethanol titrations on the assembled system indicate that the multilayer properties are also stimuli responsive with regard to solvent conditions. These results indicate that the multilayer stretch before cleavage is increased in the presence of trifluoroethanol. This was not expected from the study of the individual linker alone, indicating the need to study the system as a whole as opposed to the isolated components.

Biosensing Techniques↗
PubMed1999

Promoting sun protection in elementary schools and child care settings: the SunSafe Project.

Elementary schools and child care settings in rural New Hampshire participated in a sun protection program that reached more than 4,200 children. The program was part of a successful multifaceted community intervention targeting children ages 2-9. Program components included curricular materials, training and support for school/child care staff, and parent outreach. Evaluation showed good uptake of the curriculum by teachers and child care providers, improvements in sun protection policy in participating schools and child care settings, and significant knowledge and attitude improvements in fourth grade children tested, as well as actual behavior change. The study highlighted the importance of flexible, developmentally appropriate curricular materials and active engagement of principals and directors in policy review. In addition, for parent outreach programs to be successful, children needed to participate.

Child↗
PubMed1999

An earful.

Explore the source record for details and available documents.

Consensus Development Conferences, NIH as Topic↗
PubMed1998

Home care for the dying child. A parent's perception.

OBJECTIVES: To identify the benefits and difficulties of families caring for a dying child at home and to assess the parents' adjustment following their child's death. METHOD: Semi-structured interview and questionnaire. RESULTS: The benefits of home versus hospital care included greater freedom, more privacy and less disruption to family life, and that caring for the child was a positive experience for most families. Despite this experience many families expressed many fears and concerns about the symptomatic care of their children and requested more support. DISCUSSION: Hospital-based treatment teams have a responsibility to ensure adequate support can be provided before home care is recommended for dying children. The experience of home-based palliative care reported by these parents and their suggestions for change will assist all who care for dying children and to improve services supporting home-based palliative care.

Adolescent↗
PubMed1997

Solar protection of children at the beach.

BACKGROUND: Excessive sun exposure during childhood has been associated with subsequent development of skin cancers. Children have been advised to avoid sun exposure, use protective clothing, and apply sunscreen lotions, but how completely these recommendations are followed has not been studied. OBJECTIVE: To determine the extent of sun protection among children visiting lake beaches, the methods used, and the characteristics associated with more protection. DESIGN: Direct observations of children were linked with concurrent care giver/parent interviews. SUBJECTS/SETTING: A total of 871 children 2 to 9 years of age and their parents/care givers at freshwater beaches in 10 small New Hampshire towns during July and August 1995. OUTCOME MEASURES: Protection of the head, torso, and legs according to method used (hats, shirts, pants, sunscreen, or shade). RESULTS: Fifty-four percent of children were protected by at least one method for all three body surface regions, although 17% had no protection for any region. Sunscreen was used either alone or in combination with clothing for at least one region in 79%. Hats were used by 3%, shirts by 22%, and pants to the knee by 49%. Only 12% of observed children were in the shade. The region that was protected most often was the legs for boys (due to swim suit styles) followed by the torso for both sexes. The region most often unprotected was the legs for girls followed closely by the face for both boys and girls. Girls were significantly more likely to have no protection (31.2% female vs 7% male, chi2 83.3) due to better leg protection from swim trunks to the knees popular with boys. Full protection of all three regions was more common for children younger than 5 (odds ratio [OR] = 1.8, 95% confidence interval, [CI] 1.3-2.5), for children perceived to usually or always burn (OR = 2.0, 95% CI 1.4-2.7), for children whose parents had more than a high school education (OR = 1.8, 95% CI 1.3-2.5), and if the parents indicated receiving sun protection information from a school or clinician during the previous year (OR = 1.7, 95% CI 1.2-2.3). Approximately 51.6% of parents recalled receiving childhood solar protection advice in the past year from either their physician, a nurse, or a school/day care setting. CONCLUSIONS: Sunscreen provided the most common form of solar protection. Hats and shade were used rarely, and shirts were also underused. Although the sun protection of these children visiting the beach was substantial, nearly half were still not fully protected. Clinician advice within the past year was associated with better protection. Clinicians could increase their influence by providing more specific counseling about how to achieve full protection. Use of multiple methods of protection rather than just sunscreen and full protection rather than protection for just one or two body regions should be emphasized. It is helpful to remind families to protect the regions most frequently omitted from protection: girls' legs and boys' and girls' faces. Advice can be enhanced with patient education materials such as included in the "Slip" (on a shirt), "Slop" (on sunscreen), and "Slap" (on a hat) program developed in Australia and available through the American Cancer Society.

Adult↗
PubMed1997

Risk of squamous cell carcinoma of the skin in relation to plasma selenium, alpha-tocopherol, beta-carotene, and retinol: a nested case-control study.

We conducted a nested case-control study of squamous cell skin cancer (SCC) to determine whether risk was related to plasma concentrations of selenium, alpha-tocopherol, beta-carotene, and retinol. We derived the study sample from participants in our Skin Cancer Prevention Study, all of whom had at least one basal cell or squamous cell skin cancer before study entry. Those who developed a new squamous cell skin cancer during the 3-5-year follow-up period were selected as cases (n = 132). Controls (n = 264) were chosen at random, with matching by age, sex, and study center, from among those who did not develop SCC but were being followed actively at the time the SCC case was diagnosed. Prediagnostic plasma samples were analyzed for alpha-tocopherol, beta-carotene, and retinol using high-performance liquid chromatography. Selenium determinations were made using instrumental neutron activation analysis. Odds ratios were computed using conditional logistic regression for matched samples. We found no consistent pattern of SCC risk associated with any of the nutrients examined. The odds ratios (95% confidence intervals) for the highest versus the lowest quartiles of beta-carotene, retinol, alpha-tocopherol, and selenium were 0.73 (0.38-1.41), 1.43 (0.77-2.64), 0.89 (0.43-1.85), and 0.86 (0.47-1.58), respectively. Thus, our data add to the growing body of evidence that these nutrients, at the concentrations we evaluated, are not related strongly to SCC risk.

Adult↗
PubMed1996

Risk of basal cell and squamous cell skin cancers after ionizing radiation therapy. For The Skin Cancer Prevention Study Group.

BACKGROUND: Human evidence that ionizing radiation is carcinogenic first came from reports of nonmelanoma skin cancers (NMSCs) on the hands of workers using early radiation devices. An increased risk of NMSC has been observed among uranium miners, radiologists, and individuals treated with x rays in childhood for tinea capitis (ringworm of the scalp) or for thymic enlargement; NMSC is one of the cancers most strongly associated with the atomic bombing of Hiroshima and Nagasaki. Although exposure to ionizing radiation is a known cause of NMSC, it is not yet clear whether therapeutic radiation causes both major histologic types of NMSC, basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Additionally, the potentially modifying effects, such as latency, age when treated, and type of treatment, are not well understood. PURPOSE: We investigated the relative risks of BCC and SCC associated with previous radiation therapy and evaluated these risks in relation to age and time since initial treatment and the medical condition for which radiation therapy was given. METHODS: The study group comprised individual diagnosed with at least one BCC or SCC from January 1980 through February 1986, who were recruited to participate in a skin cancer prevention trial designed to test whether oral beta-carotene supplementation would reduce the risk of new NMSCs. Patients were identified through the dermatology and pathology records of academic medical centers in Hanover, NH; Los Angeles, CA; San Francisco, CA; and Minneapolis, MN. Each participant completed a questionnaire detailing lifetime residence, pigmentary characteristics, occupational and recreational sun exposure, and history of radiation therapy. At enrollment, a study dermatologist assessed skin type (tendency to burn or tan) and extent of actinic skin damage. Participants were followed with an annual dermatologic examination for an average of 4 years. Of the 5232 potentially eligible individuals, 1805 were enrolled in the trial. We excluded 112 patients who reported previous radiation therapy for skin cancer only and three with missing information on whether they were ever treated with radiation therapy, leaving 1690 patients for the analysis. Approximately 4% of the patients died or discontinued participation for other reasons during each study year. We examined time to occurrence of first new histopathologically confirmed BCC and SCC during the follow-up period in relation to history of radiation therapy (for reasons other than NMSC) using a proportional hazards model. A multiple end points survival model was used to compare the rate ratios (RRs) for BCC and SCC. We also used a longitudinal method of analysis to compute the RR of total new BCC and SCC tumors per person per study year associated with radiation therapy. Using this method, we additionally assessed the potential modifying effects of age at treatment, latency, and type of therapy. All P values were derived from two-sided statistical tests of significance. RESULTS: Among the participants we studied, 597 developed a new BCC (n = 1553 tumors) and 118 developed a new SCC (n = 179 tumors). The time to first new BCC, but not SCC, was associated with prior radiation therapy (RR = 1.7; 95% confidence interval [CI] = 1.4-2.0 and RR = 1.0; 95% CI = 0.6-1.7, respectively; P = .03 for the difference between the RRs). The RR of total BCC tumors was slightly higher (RR = 2.3; 95% CI = 1.7-3.1), but it was still unity for SCC (RR = 1.0; 95% CI = 0.5-1.9). BCC risk appeared to increase with younger age at exposure and time since initially treated, although these effects were only marginally statistically significant (P for trend = .06 and .07, respectively). Also, risk of BCC was more strongly related to treatment for acne (RR = 3.3; 95% CI = 2.1-5.2) than other conditions. CONCLUSIONS AND IMPLICATIONS: Our data suggest that exposure to therapeutic radiation is associated with BCC but not with SCC.

Adult↗
PubMed1996

Mortality associated with low plasma concentration of beta carotene and the effect of oral supplementation.

OBJECTIVE: To examine the relationship between beta carotene plasma concentration and beta carotene supplementation and risk of death from major disease causes. DESIGN: Cohort study of plasma concentrations; randomized, controlled clinical trial of supplementation. SETTING: Medical school-affiliated dermatology practices. PATIENTS: A total of 1188 men and 532 women with mean age of 63.2 years, who had enrolled in a randomized clinical trial of beta carotene supplementation to prevent nonmelanoma skin cancer. INTERVENTION: Oral beta carotene, 50 mg per day for a median of 4.3 years. MAIN OUTCOME MEASURES: All-cause mortality and mortality from cardiovascular disease and cancer. RESULTS: During a median follow-up period of 8.2 years, there were 285 deaths. Persons whose initial plasma beta carotene concentrations were in the highest quartile (>0.52 micromol/L [27.7 microg/dL]) had a lower risk of death from all causes (adjusted relative rate [RR], 0.52; 95% confidence interval [CI] 0.44 to 0.87) and from cardiovascular diseases (adjusted RR, 0.57; 95% CI, 0.34 to 0.95) compared with persons with initial concentrations in the lowest quartile (<0.21 micromol/L [11.2 microg/dL]). Patients randomly assigned to beta carotene supplementation showed no reduction in relative mortality rates from all causes (adjusted RR, 1.03; 95% CI, 0.82 to 1.30) or from cardiovascular disease (adjusted RR, 1.16; 95% CI, 0.82 to 1.64). There was no evidence of lower mortality following supplementation among patients with initial beta carotene concentrations below the median for the study group. CONCLUSIONS: These analyses provide no support for a strong effect of supplemental beta carotene in reducing mortality from cardiovascular disease or other causes. Although the possibility exists that beta carotene supplementation produces benefits that are too small or too delayed to have been detected in this study, noncausal explanations should be sought for the association between plasma concentrations of beta carotene and diminished risk of death.

Administration, Oral↗