Ossified adrenocortical adenoma: an unusual radiological and morphological appearance.
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Adenoma↗
Biomedical subjects
Richard M Martin
Publications and source records attributed to Richard M Martin.
Breast feeding and cardiovascular disease risk factors, incidence, and mortality: the Caerphilly study.
STUDY OBJECTIVE: To investigate the association of having been breast fed with cardiovascular disease risk factors, incidence, and mortality. DESIGN: Prospective cohort study. SETTING: Caerphilly, South Wales. PARTICIPANTS: All men aged 45-59 years living in and around the study area. Of 2818 eligible men, 2512 (89%) were seen. Altogether 1580 men (63%) obtained details of how they had been fed in infancy (ever breast fed or only bottle fed) from their mother or a close female relative. A subset of 1062 subjects reported on whether bottle fed or the duration of breast feeding if breast fed. MAIN RESULTS: Breast feeding was not associated with stature, blood pressure, insulin resistance, total cholesterol, or fibrinogen. In fully adjusted models (controlling for age, birth order, and social position in childhood and adulthood), breast feeding was associated with greater body mass index than bottle feeding (difference: 0.41 kg/m(2) (95% CI: 0.01 to 0.81). There was a positive association between breast feeding and coronary heart disease mortality (hazard ratio: 1.73; 1.17 to 2.55) and incidence (1.54; 1.17 to 2.04) (fully adjusted models). There was no evidence of a duration-response effect, which might be expected if an adverse effect of breast feeding was causal. CONCLUSION: These data provide little evidence of a protective influence of breast feeding on cardiovascular disease risk factors, incidence, or mortality. A possible adverse effect of breast feeding on coronary heart disease incidence was observed but may have a number of explanations, including selection and information bias. In view of these limitations, further long term studies with improved measures of infant feeding are required to confirm or refute these findings.
Body Height↗
Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence.
OBJECTIVE: To examine the influence of initial infant feeding on obesity in later life. METHODS: A systematic review of published studies investigating the association between infant feeding and a measure of obesity was performed with Medline (1966 onward) and Embase (1980 onward) databases, supplemented with manual searches. Data extraction was conducted by 2 authors. Analyses were based on odds ratios of obesity among initially breastfed subjects, compared with formula-fed subjects, pooled with fixed-effects models. RESULTS: Sixty-one studies reported on the relationship of infant feeding to a measure of obesity in later life; of these, 28 (298900 subjects) provided odds ratio estimates. In these studies, breastfeeding was associated with a reduced risk of obesity, compared with formula feeding (odds ratio: 0.87; 95% confidence interval [CI]: 0.85-0.89). The inverse association between breastfeeding and obesity was particularly strong in 11 small studies of <500 subjects (odds ratio: 0.43; 95% CI: 0.33-0.55) but was still apparent in larger studies of > or =500 subjects (odds ratio: 0.88; 95% CI: 0.85-0.90). In 6 studies that adjusted for all 3 major potential confounding factors (parental obesity, maternal smoking, and social class), the inverse association was reduced markedly (from an odds ratio of 0.86 to 0.93) but not abolished. A sensitivity analysis examining the potential impact of the results of 33 published studies (12505 subjects) that did not provide odds ratios (mostly reporting no relationship between breastfeeding and obesity) showed little effect on the results. CONCLUSIONS: Initial breastfeeding protects against obesity in later life. However, a further review including large unpublished studies exploring the effect of confounding factors in more detail is needed.
Breast Feeding↗
Childhood body mass index and later cancer risk: a 50-year follow-up of the Boyd Orr study.
Associations between childhood BMI and adult cancer risk were investigated in a historical cohort study based on the Carnegie ("Boyd Orr") Survey of Diet and Health in Pre-War Britain (1937-9). In 14 centres in England and Scotland, children had their height and weight measured. We included 2,347 individuals aged between 2 and 14 years 9 months at the time of measurement, who were traced through the National Health Service Central Register. Relative cancer risk (registration or death) was estimated in relation to age- and sex-specific BMI SD scores. We studied associations with (i) all cancers, (ii) cancer groups stratified according to their relationship to smoking and (iii) certain site-specific cancers. In the 50 years of follow-up, 188 men and 192 women developed cancer. There was a 9% increase (95% CI -3 to 22%) in risk of cancer in adulthood per SD increase in BMI measured in childhood. There was no evidence of confounding by childhood or adulthood socioeconomic position, other anthropometric variables, childhood energy intake or birth order. There was a 30% increase (95% CI 10-54%) in risk of smoking-related cancers per SD increase in childhood BMI. There was no relationship between BMI and cancers not related to smoking. Associations for all cancers and non-smoking-related cancers tended to be stronger in children who were measured at an older (>8 years) rather than a younger (< or =8 years) age. We conclude that childhood BMI is related to increased risk of cancer in later life, particularly smoking-related cancers.
Adolescent↗
Lessons from the withdrawal of rofecoxib.
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Anti-Inflammatory Agents, Non-Steroidal↗
Role of spin-orbit splitting and dynamical fluctuations in the Si(557)-Au surface.
Our ab initio calculations show that spin-orbit coupling is crucial to understand the electronic structure of the Si(557)-Au surface. The spin-orbit splitting produces the two one-dimensional bands observed in photoemission, which were previously attributed to spin-charge separation in a Luttinger liquid. This spin splitting might have relevance for future device applications. We also show that the apparent Peierls-like transition observed in this surface by scanning tunneling microscopy is a result of the dynamical fluctuations of the step-edge structure which are quenched as the temperature is decreased.
Journal Article↗
Prediction of new phases of nitrogen at high pressure from first-principles simulations.
A rich variety of competing phases is predicted for nitrogen at accessible pressures, including a new metallic chainlike phase very close in energy to the previously predicted cubic gauche phase, and other phases at slightly higher energies, e.g., one with N2 and N6 units. Large energy barriers between structures can account for recent observations of metastability, and we identify a low barrier transition path from the known epsilon phase to the chainlike metallic phase. In analogy to MgB2, the metal is anisotropic with multiple Fermi surfaces formed from pi and sigma states.
Journal Article↗
Does breast-feeding in infancy lower blood pressure in childhood? The Avon Longitudinal Study of Parents and Children (ALSPAC).
BACKGROUND: Breast-feeding in infancy has been associated with decreased coronary heart disease mortality, but the underlying mechanisms are unclear. We investigated the association of breast-feeding with blood pressure in a contemporary cohort. METHODS AND RESULTS: In a prospective cohort study (ALSPAC, United Kingdom), a total of 7276 singleton, term infants born in 1991 and 1992 were examined at 7.5 years. Complete data were available for 4763 children. The systolic and diastolic blood pressures of breast-fed children were 1.2 mm Hg lower (95% CI, 0.5 to 1.9) and 0.9 mm Hg lower (0.3 to 1.4), respectively, compared with children who were never breast-fed (models controlled for age, sex, room temperature, and field observer). Blood pressure differences were attenuated but remained statistically significant in fully adjusted models controlling for social, economic, maternal, and anthropometric variables (reduction in systolic blood pressure: 0.8 mm Hg [0.1 to 1.5]; reduction in diastolic blood pressure: 0.6 mm Hg [0.1 to 1.0]). Blood pressure differences were similar whether breast-feeding was partial or exclusive. We examined the effect of breast-feeding duration. In fully adjusted models, there was a 0.2-mm Hg reduction (0.0 to 0.3) in systolic pressure for each 3 months of breast-feeding. CONCLUSIONS: Breast-feeding is associated with a lowering of later blood pressure in children born at term. If the association is causal, the wider promotion of breast-feeding is a potential component of the public health strategy to reduce population levels of blood pressure.
Adult↗
Breastfeeding and cardiovascular mortality: the Boyd Orr cohort and a systematic review with meta-analysis.
AIMS: To investigate the association of breastfeeding with all-cause, cardiovascular, and ischaemic heart disease mortality. METHODS AND RESULTS: A long-term follow-up of 4999 children originally surveyed from 1937 to 1939 was undertaken (Boyd Orr cohort). Four thousand three hundred and seventy-nine subjects (88%) were traced in adulthood and 3555 (71%) had complete data on all covariates. The results were combined with a meta-analysis of the published literature. In the Boyd Orr study, there was little evidence that breastfeeding was associated with all-cause (hazard ratio: 1.04 [95% CI: 0.90-1.20]), cardiovascular (1.04 [0.83-1.30]), or ischaemic heart disease (1.02 [0.77-1.36]) mortality, compared with bottle-feeding. Meta-analyses of observational studies showed little evidence of an association of breastfeeding with all-cause (pooled rate ratio: 1.01 [95% CI: 0.91-1.13]) or cardiovascular (1.06 [0.94-1.20]) mortality. There was a moderate-to-high degree of between-study heterogeneity for the association between breastfeeding and ischaemic heart disease mortality (I2 value-indicating the degree of between-study variation attributable to heterogeneity-66%), and estimates were consistent with both an important beneficial or adverse effect of breastfeeding. CONCLUSION: There is little consistent evidence that breastfeeding influences subsequent all-cause or cardiovascular disease mortality. Results from other well-designed cohorts may clarify residual uncertainty.
Breast Feeding↗
Parents' growth in childhood and the birth weight of their offspring.
BACKGROUND: A person's birth weight is inversely related to both their own and their parents' cardiovascular disease mortality risk, but mechanisms underlying such transgenerational associations are unclear. We investigated the influence of the childhood growth of the mother or father on the birth weight of their first-born offspring. METHODS: We used data from the long-term follow up (in 1997-1998) of 4999 children from 1352 families who participated in the Boyd Orr Survey of Diet and Health in Pre-War Britain (1937-1939). Complete information on childhood height, potential confounding variables, and the birth weight of first-born offspring was available for 637 subjects. RESULTS: Mother's height in childhood was positively associated with her offspring's birth weight. Leg length, but not trunk length, was the component of maternal height associated with offspring birth weight. For each unit increase in z-score for maternal childhood leg length, there was a 96-g (95% confidence interval = 6-186) increase in offspring birth weight after controlling for childhood socioeconomic variables and adult height. There were weaker positive associations of paternal height and leg length in childhood with offspring birth weight. Associations were not confounded by maternal birth weight or midgrandparental height. CONCLUSIONS: Our findings are consistent with the hypothesis that maternal growth during childhood influences offspring birth weight, independently of maternal birth weight, final attained height, or midgrandparental height. Because leg length is a sensitive marker of adverse nutritional and social exposures during childhood, these results suggest a key role for a mother's early environmental exposures as a determinant of her child's subsequent health.
Adult↗
Patterns of General Practitioner consultation for mental illness by young people in rural areas. A cross-sectional study.
The prevalence of psychiatric morbidity appears to be lower in rural than urban areas. Using the Fourth National GP Morbidity Survey (1991-1992) we have compared patterns of GP consultation for mental illness by young people living in rural and urban areas to investigate whether patterns of morbidity are reflected in GP help-seeking. We investigated whether urban-rural differences were due to differences in the socio-economic characteristics of residents. The crude rate ratio for consultation for mental disorder in rural compared to urban males was 0.55 (95% Cl 0.47 to 0.65) and for females was 0.78 (0.71 to 0.86). After controlling for socioeconomic differences between rural and urban areas, consultation rates for mental illness were 30% (95% Cl 19% to 41%) lower in males and 16 per cent (8% to 24%) lower in females in rural compared to urban areas. These findings are in line with population surveys indicating that levels of mental illness are lower in rural compared to urban areas. Part of the difference economic characteristics of people living in these areas. Further studies are needed to investigate possible area effects on the prevalence of mental illness. reflects differences in the socio-
Adolescent↗
Condensed-matter physics: Hydrogen falls into line.
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Comment↗
NHS waiting lists and evidence of national or local failure: analysis of health service data.
OBJECTIVES: To investigate the national distribution of prolonged waiting for elective day case and inpatient surgery, and to examine associations of prolonged waiting with markers of NHS capacity, activity in the independent sector, and need. SETTING: NHS hospital trusts in England. POPULATION: People waiting for elective treatment in the specialties of general surgery; ear, nose and throat surgery; ophthalmic surgery; and trauma and orthopaedic surgery. MAIN OUTCOME MEASURE: Numbers of people waiting six months or longer (prolonged waiting). Characteristics of trusts with large numbers waiting six months or longer were examined by using logistic regression. RESULTS: The distribution of numbers of people waiting for day case or elective surgery in all the specialties examined was highly positively skewed. Between 52% and 83% of patients waiting longer than six months in the specialties studied were found in one quarter of trusts, which in turn contributed 23-45% of the national throughput specific to the specialty. In general, there was little evidence to show that capacity (measured by numbers of operating theatres, dedicated day case theatres, available beds, and bed occupancy rate) or independent sector activity were associated with prolonged waiting, although exceptions were noted for individual specialties. There was consistent evidence showing an increase in prolonged waiting, with increased numbers of anaesthetists across all specialties and with increased bed occupancy rates for ear, nose and throat surgery. Markers of greater need for health care, such as deprivation score and rate of limiting long term illness, were inversely associated with prolonged waiting. CONCLUSION: In most instances, substantial numbers of patients waiting unacceptably long periods for elective surgery were limited to a small number of hospitals. Little and inconsistent support was found for associations of prolonged waiting with markers of capacity, independent sector activity, or need in the surgical specialties examined.
Ambulatory Surgical Procedures↗
Infant nutrition and blood pressure in early adulthood: the Barry Caerphilly Growth study.
BACKGROUND: Evidence suggests that environmental factors acting early in life may affect blood pressure in adulthood. OBJECTIVE: The objective was to test the hypothesis that dried formula milk (derived from cow milk) intake in infancy is positively associated with blood pressure in early adulthood. DESIGN: We conducted a long-term follow-up (1997-1999) of the Barry Caerphilly Growth study cohort (1972-1974) into which mothers and their offspring had originally been randomly assigned to receive a milk supplement or usual care. Participants were the offspring, who were aged 23-27 y at follow-up. The main outcome measures were systolic and diastolic blood pressure. RESULTS: The social and demographic characteristics of the subjects who were (n = 679) and were not (n = 272) followed up were similar. For each increase in quartile of dried milk consumption (in oz) at 3 mo of age, there was a 1.28-mm Hg (95% CI: 0.46, 2.10 mm Hg) increase in systolic and a 0.63-mm Hg (95% CI: 0.04, 1.22 mm Hg) increase in diastolic blood pressure after adjustment for sex, intervention group, birth weight z scores, social class in childhood, age at follow-up, alcohol consumption, and pack-years of smoking. These coefficients were attenuated when adult body mass index and height were included in the models, but the association of dried milk consumption at 3 mo of age with systolic pressure remained significant (1.07 mm Hg; 95% CI: 0.27, 1.87 mm Hg). CONCLUSIONS: Our findings are consistent with the hypothesis that high blood pressure in later life is influenced by early postnatal nutrition. Thus, interventions to optimize infant nutrition may have important long-term health benefits.
Adult↗