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Biomedical subjects

Y Ben-Shlomo

Publications and source records attributed to Y Ben-Shlomo.

11 recordsLinked to original sources
PubMed1992

Serum cholesterol concentration and primary malignant brain tumors: a prospective study.

Case-control studies and a prospective study have suggested a positive relation between serum cholesterol and brain tumors. To examine this association further, mortality from malignant brain tumors among men who participated in the Multiple Risk Factor Intervention Trial (a prospective study, 1973-1986) who indicated they were not black were examined. No relation was seen between age-standardized mortality rates and baseline serum cholesterol. Excluding deaths occurring during the first 5 years or adjusting for median census tract income did not alter this finding. This suggests that no generalizable relation between serum cholesterol and primary malignant brain tumors exists. An environmental factor associated with serum cholesterol in some, but not all populations, may explain the apparently contradictory results.

Adult↗
PubMed1992

Prediction of general practice workload from census based social deprivation scores.

STUDY OBJECTIVE: The aim was to compare the ability of census based social deprivation scores devised by Jarman, Carstairs, and Townsend to predict workload in general practice. DESIGN: This was a prospective study of 140,050 patients registered with general practices over one year from 1 July 1981 (Third National Morbidity Survey). Main outcome measures were workload score for each patient, defined as a weighted sum of consultations at the surgery and consultations elsewhere, excluding preventive procedures. SETTING: 25 general practices in England and Wales. MAIN RESULTS: In multivariate analyses the Jarman, Carstairs, and Townsend indices all predicted workload, but the Townsend index was the best predictor, with both housing tenure and car ownership being strong predictors of workload. The overcrowding and geographical mobility variables used in the Jarman index did not predict increased workload. The weighting assigned to children under five by the Jarman index underestimated the additional workload this group generated. CONCLUSIONS: For identifying social pressures on general practice workload the Jarman index is less valid than other census based scores because it fails to include car ownership and housing tenure. A more rational scheme for compensating general practitioners would directly weight the capitation fee for children aged under five years and allocate current deprivation payments according to the Townsend index or a similar score. This would redistribute resources from London to deprived areas in northern England.

Adolescent↗
PubMed1992

Dietary fat in the epidemiology of multiple sclerosis: has the situation been adequately assessed?

Epidemiological studies have demonstrated that environmental influences contribute to determining the risk of multiple sclerosis (MS). The nature of this influence has not been established, although infectious agents have received the most attention with relative neglect of alternative hypotheses. This paper critically reviews the evidence implicating dietary fat in altering susceptibility to MS. It is concluded that a dietary theory accords with current knowledge regarding MS as well as an infective theory and thus should not be dismissed in research examining the aetiology of MS.

Case-Control Studies↗
PubMed1992

Stroke risk from alcohol consumption using different control groups.

BACKGROUND AND PURPOSE: Our aim in this study was to investigate the relation between chronic alcohol consumption and stroke. METHODS: A case-control study was carried out using two hospital-based control groups and the results of a community-based survey of alcohol consumption. Hospital-based control subjects were chosen either from "general" medical admissions or a subset of "select" admissions that excluded possible alcohol-related admissions. Cases were selected from hospital inpatients. RESULTS: The relative risk for stroke associated with alcohol consumption greater than 300 grams per week for general control subjects was 0.73 (95% confidence interval [CI], 0.54-3.49) compared with 1.30 (95% CI, 0.42-4.05) for select control subjects. The odds ratio was further increased to 1.93 (95% CI, 0.87-4.28) using data from the community-based survey. None of these estimates were statistically significant. CONCLUSIONS: These results illustrate how the risk associated with alcohol consumption varies depending on the choice of control groups and may explain the contradictory results from previous case-control studies. Because of different biases associated with control selection, we believe that the results of this study are consistent with those of other studies that demonstrate a modest increased risk for stroke associated with alcohol consumption.

Adult↗
PubMed1992

What features improve the accuracy of clinical diagnosis in Parkinson's disease: a clinicopathologic study.

Many authorities have drawn attention to the difficulties in clinically distinguishing Parkinson's disease (PD) from other parkinsonian syndromes. We assessed the clinical features of 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic PD according to their pathologic findings. Seventy-six percent of these cases were confirmed to have PD. By using selected criteria (asymmetrical onset, no atypical features, and no possible etiology for another parkinsonian syndrome) the proportion of true PD cases identified was increased to 93%, but 32% of pathologically confirmed cases were rejected on this basis. These observations suggest that studies based on consultant diagnosis of PD, using standard diagnostic criteria, will include cases other than PD, thus distorting results from clinical trials and epidemiologic studies. The strict use of additional criteria can reduce misdiagnosis but at the cost of excluding genuine PD cases.

Adult↗
PubMed1991

Deprivation in infancy or in adult life: which is more important for mortality risk?

Previous ecological studies have suggested that early life factors are important causes of adult cardiovascular and respiratory disease, by showing geographic correlations between past infant mortality rates and present adult mortality rates. However, these studies inadequately take account of the fact that areas which were severely deprived earlier this century remain the most deprived today. Thus the ecological relation between infant and adult mortality rates could simply reflect persistence in the geographic distribution of poor socioeconomic circumstances. To explore this hypothesis further infant mortality rates for 1895-1908 for 43 counties in England and Wales were correlated with cause-specific adult mortality for 1969-73 in people aged 65-74 years, with and without adjustment for present-day social deprivation and social class. The strong simple correlations found between infant mortality in 1895-1908 and adult mortality from various causes in 1969-73 were generally much attenuated or abolished by controlling for indices of present-day socioeconomic circumstances. Our results suggest that previous studies give no strong support for any direct influence of factors acting in early life on adult coronary heart disease mortality risk. Studies which gather data about infancy, childhood, and the full course of adult life are required to clarify this issue.

Adult↗