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PubMed1989

Alcohol consumption and cancers of hormone-related organs in females.

The relations between alcohol consumption and cancers of the breast, corpus uteri and ovary were investigated in a case-control study involving 1,740 cases of breast cancer, 239 cases of cancer of the corpus uteri, 417 cases of ovarian cancer and 8,920 controls with other cancer sites identified from the Aichi Cancer Registry, Japan 1980-1986. The age-adjusted relative risk (RR) of daily alcohol drinkers compared to non-drinkers was significantly increased for breast cancer (RR = 1.36, 95% confidence interval (CI) 1.04-1.78), that for cancer of the corpus uteri was lowered insignificantly (RR = 0.44, 95% CI 0.15-1.38) and that for ovarian cancer was significantly lowered (RR = 0.38, 95% CI 0.16-0.90). The increase in the risk of breast cancer associated with daily alcohol drinking was evident in the age range 50 and over, the risk specified by type of alcoholic beverage being highest for beer. Multivariate analyses controlled for age, residence, marital status, occupation, smoking habit and family history of breast cancer did not materially change the RRs of daily alcohol drinkers. Despite the several limitations of the study, the results were consistent with those of previous studies from other countries, suggesting that alcohol consumption may contribute to the risk of breast cancer in Japanese woman, as it dose elsewhere. The present study also suggested alcohol consumption not to be associated with elevated risks of cancer in other hormone-related organs in females, and possibly to be associated with a decreased risk of ovarian cancer.

Adult↗
PubMed1987

Vitamin D status of two groups of elderly in Oslo: living in old people's homes and living in own homes.

Vitamin D status of two groups of elderly was determined by measuring serum concentrations of 25-hydroxyvitamin D3 (25-OHD), and dietary and supplemental vitamin D intake. Group A consisted of 35 women (mean age 86 years), and 21 men (mean age 80 years) living in 5 different homes for elderly. Group B consisted of free-living elderly, 24 women (mean age 76 years) and 7 men (mean age 79 years). There was no or little seasonal variation in serum 25-OHD concentrations in either group. Of those who did not use vitamin D supplements, 83% of the women and 77% of the men in group A, and 40% of the women and none of the men in group B had 25-OHD concentrations below 20 ng/ml in the winter serum samples. Of the 49 individuals who used supplements, only 2 had values below 20 ng/ml. In the institutionalized elderly, 14-15 micrograms vitamin D per day as supplement was associated with a mean increase in 25-OHD concentration in winter serum samples of 25 ng/ml. Dietary intakes of vitamin D were low for both groups, especially for the women (less than 3 micrograms). It is concluded that elderly Norwegians, in particular those living in institutions, ought to improve their vitamin D status by increasing their exposure to sunshine and by including more oily fish in their diet. If this is difficult to achieve, vitamin D supplement (10 micrograms/day) should be used.

Aged↗
PubMed1987

Independent living for high-lesion quadriplegics.

A formal evaluation of the Creekview project has been completed by the B.C. provincial government and CPA. This evaluation will determine the costs/benefits of Creekview as a model for future moves of severely disabled persons into the community. The evaluation looked at several issues such as operating costs, health status of residents at the time of relocation and one year later, quality of attendant staff, standards of care and general level of services provided. Pearson Hospital continues to play a role in the support of the Creekview project.

Activities of Daily Living↗
PubMed1978

Incest in psychiatric practice: a description of patients and incestuous relationships.

Patients reporting incest resembled the author's other patients in age, sex marital status, education, residence and social class. Both initiating and receptive partners were represented among these patients. In two-thirds of 32 patients, incest had occurred more than 1 year previously. No one clinical picture predominated. Thirty-two patients had been involved in 42 incestuous relationships. Initiating partners, always older, included 32 men and 10 women. Coitus was the most frequent sexual activity; homosexual relations were present in 4 instances. Adults initiating incest had usually lost access to adult sexual partners by death, divorce, illness, or marital partners' refusal to cohabit.

Adolescent↗
PubMed1981

Cross-sectional study of a community with exceptional exposure to DDT.

The geometric mean level of total DDT in serum samples (76.2 ng/mL) from 499 persons living downstream from a defunct DDT-manufacturing plant was several times the national geometric mean (15.0 ng/mL). DDE isomers, metabolites of DDT, accounted for an average of 86.7% of total DDT. Total DDT levels increased with age, even when controlled for other independent variables also significantly associated with DDT: race, sex, fish consumption, years of residence, socioeconomic status, alcohol consumption, and serum triglyceride levels. Fish consumption, the second strongest determinant of DDT level, had one third the predictive power of age. Total DDT levels were not associated with specific illness or ill health. However, total DDT levels were positively associated with levels of serum cholesterol, triglyceride, and gamma-glutamyl transpeptidase. The finding that serum DDE levels increase with age suggests that no equilibrium in body burden has been reached or that pharmacokinetics or serum/adipose partition may vary with age.

Adolescent↗
PubMed1993

Evaluation of the efficacy of routine BCG vaccination: a case-control study.

A case-control study was conducted in a metropolitan region of Cairo, Egypt to determine the protective efficacy of routine BCG Vaccination of infants against childhood pulmonary tuberculosis. A total of 175 cases of children suffering from pulmonary tuberculosis were obtained over 8 months period from hospitals likely to admit such cases in Cairo. Each case was matched to two controls for the district of residence. Vaccination status of cases and controls was ascertained by asking the mothers and confirmed by examination of the left arm of the study children for the scar of BCG vaccination. The overall crude efficacy of BCG vaccination was found to be 53% (CL: 68%, 31%), dropping to 49% (CL: 57%, 25%) after controlling for the confounding effect of crowding index. Potential biases in the study design and their role in over or underestimation of the vaccine efficacy were discussed.

BCG Vaccine↗
PubMed1994

Using antiviral agents to control outbreaks of influenza A infection.

Risk of influenza mortality is high among older Americans and especially so among those residing in nursing homes. Current recommendations call for annual vaccination of all nursing home residents and staff against type A influenza, but outbreaks can and do occur even in homes with high vaccination rates. If an outbreak occurs, all residents--whether ill or not--should receive an antiviral drug, and prophylaxis should be initiated regardless of residents' vaccination status. The antiviral agents rimantadine and amantadine are both effective for prophylaxis and treatment of type A influenza, but rimantadine appears to cause fewer CNS side effects.

Aged↗
PubMed1994

[A social study of a group of depressed patients recovering in a private clinic].

Depression is a widespread illness in Sardinia and is treated mainly in private clinics which accept National Health patients. The aim of the present study was to evidence socio-demographic and clinical characteristics of depressed subjects who turn to these clinics. Furthermore we will examine the reason which led to the choice of a private clinic on the basis of services provided by the same, of those available in public hospitals and of patients' psychopathological history and socioeconomic characteristics. We examined 122 depressed patients who had been admitted to a private clinic in Cagliari over a period of six months. By means of a data collection sheet the following parameters were studied: sex, age, place of birth and residence, marital status, family nucleus, profession, level of education, head of the family's occupation, receipt of pension or subsidy, geriatric or other forms of assistance, diagnosis, age at onset of illness, characteristics of current episode, previous hospitalizations, treatment received (public or private), structures usually applied to patients, social welfare aid and reason for the same, psychiatric structures available locally, persons who had requested current and previous hospitalization, reason which had led to choice of clinic. Examination of data collected revealed that females are hospitalized (94.27%) more than males (5.73%); this finding is in agreement with data reported in the literature which evidence a higher incidence of depression among females. The majority of patients were in the over-50 age group (56.5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Smoking and risk of rheumatoid arthritis.

OBJECTIVE: To investigate smoking for its association with the incidence of seropositive and seronegative rheumatoid arthritis (RA). METHODS: A cohort of adult Finns was examined by the Social Insurance Institution's Mobile Clinic in 1966-72. The 24,445 women and 28,364 men who had neither arthritis nor a history of it at the start of the study were followed until the end of 1989 using record linkage with the Institution's population register to identify patients entitled to free antirheumatic medication. Sufficient information was obtained on 512 incident cases of RA, of whom 119 men and 229 women were seropositive and 42 men and 122 women seronegative. RESULTS: There was a close association between smoking and the incidence of seropositive RA in men. It was not due to confounding by age, geographical location of residence, marital status, social class, self-perceived general health, or body mass index, although these factors correlated with smoking history. As adjusted for these factors, the relative risk of seropositive RA was 2.6 (95% confidence interval, 1.3-5.3) in male ex-smokers and 3.8 (95% confidence interval, 2.0-6.9) in current smokers, in comparison with the men who had never smoked. The association persisted throughout the entire followup period, but it was most distinct after the first 14 years of followup. Smoking did not predict seropositive RA in women, nor was it predictive of seronegative RA in men or women. CONCLUSION: Exposure to tobacco smoke, or some factor or cluster of factors associated with smoking, may trigger the production of rheumatoid factors and, in interaction with the male sex, subsequently contribute to the development of clinically manifest RA.

Adolescent↗
PubMed1995

Use of cancer-screening tests in the San Francisco Bay area: comparison of Latinos and Anglos.

BACKGROUND: Compared with Anglos (non-Latino whites), incidences of breast and colorectal cancers are lower for Latinos and incidences of cervical cancer are higher for Latinos. In regional and national studies, Latinos obtain fewer cancer screening tests for cervical, breast, and colorectal cancers when compared with Anglo populations. It remains unclear if these differences are due solely to socioeconomic status. PURPOSE: To evaluate self-reported use of these tests by ethnicity, we conducted telephone interviews about the use of the Pap smear, clinical breast examination, mammogram, rectal examination, fecal occult blood test, and sigmoidoscopy. METHODS: Cross-sectional, random-digit dialing telephone surveys of Latino and Anglo adults, 35-74 years of age, living in San Francisco and Alameda Counties, Calif. were used. A total of 798 Latinos (398 men and 408 women) and 436 Anglos (214 men and 222 women) completed the interview. RESULTS: Age-adjusted rates showed that 82.0% of Latinas reported a Pap smear within 3 years compared with 85.1% of Anglo women. A clinical breast examination within 2 years was reported by 82.1% of Latinas and by 88.9% of Anglo women. Screening mammograms within 2 years were reported by 57.8% of Latinas and by 72.3% of Anglo women (difference = -14.5%; 95% confidence interval [CI] = -21.5, -7.5). Compared with Anglos, fewer Latinos reported digital-rectal examinations within 2 years (44.6% versus 61.8%; difference = -17.2%; 95% CI = -22.6, -11.8). There were no significant differences by ethnicity in obtaining a fecal occult blood test within 2 years (32.3% versus 34.0%) and sigmoidoscopy within 5 years (18.9% versus 21.5%). After adjusting for age, education, health insurance, employment, marital status, county of residence, and self-perceived health status, Latino ethnicity was a significant predictor only for digital-rectal examination within 2 years (odds ratio [OR] = 0.65; 95% CI = 0.49-0.86) and digital-rectal examination ever (OR = 0.54; 95% CI = 0.40-0.74). Latinos were significantly more likely to cite forgetfulness, lack of transportation, long wait for appointments, and need for child care as reasons for not having cancer screening tests. CONCLUSION: We conclude that after accounting for socioeconomic factors, Latino ethnicity is a relatively minor predictor of use of cancer screening tests. Increasing the availability of culturally appropriate educational materials and providing universal health care coverage are more important priorities to promote appropriate use of cancer screening tests by Latinos.

Adult↗
PubMed1995

Dietary practices, alcohol consumption, and smoking behavior: ethnic, sex, and acculturation differences.

Current knowledge is scarce on Latino dietary practices. This study compared the dietary practices, alcohol consumption, and smoking behavior of Latinos and non-Latino whites in two randomly selected samples. Telephone surveys of adults 35-74 years of age from the Kaiser Permanente Medical Care Program (Latinos = 844; non-Latino whites = 510) and from census tract-based areas (Latinos = 806; non-Latino whites = 436) were conducted in the San Francisco Bay Area. Latino ethnicity was a significant predictor of dietary and alcohol consumption practices in multivariate logistic regression models after adjustment for sex, education, age, employment, health insurance, martial status, county of residence, and self-perceived health status. Compared with non-Latino whites, Latinos were significantly less likely to report eating vegetables and more likely to eat rice, beans, and fried foods and to drink whole milk. Less acculturated Latinos were more likely to eat fruits, rice, beans, meat, and fried foods and to drink whole milk than more acculturated Latinos. Latino men were significantly more likely to be binge drinkers, and Latina women were significantly more likely to abstain from drinking alcohol during the month prior to the interview. As Latina women acculturate to the U.S. mainstream, they report more cigarette smoking and alcohol consumption. Although Latinos reported higher levels of selected high-fiber foods, the low consumption of vegetables, widespread use of saturated fat, and the heavy drinking and smoking among Latino men, which are associated with the level of acculturation, may increase the risk for cancer. Educational messages targeting less acculturated Latinos should focus on maintaining their current healthy dietary practices of eating fruits, rice, and beans and decreasing their fat consumption. For more acculturated Latinos, emphasis should be placed on resuming the traditional diet.

Acculturation↗
PubMed1996

Population health and health care use: an information system for policy makers.

University-based researchers in Manitoba, Canada, have used administrative data routinely collected as part of the national health insurance plan to design a population-based health information system (POPULIS). Decision-makers can use this system to make critical comparisons across regions of residents' health status, socioeconomic risk characteristics, and use of hospitals, nursing homes, and physicians. Policy makers have found this information system useful in providing answers to questions they are often asked: Which populations need more physician services? Which need fewer? Are high-risk populations poorly served or do they have poor health outcomes despite being well served? Does high utilization represent overuse or is it related to high need? Three commentaries follow.

Database Management Systems↗
PubMedDate not supplied

[Incidence of eye diseases in inhabitants of the Koryak Autonomous Territory].

This study was aimed at comprehensive examination of the visual status of residents of the Northern regions within the frames of investigations on the problem of vision deterioration in the residents of the North. The study covered seven regions of the Koryak Autonomous Territory. A total of 1067 patients were examined, 30% of these were children aged mostly from 6 to 12. About half the examinees were indigenous population of the North. On the whole, the results coincide with previous findings. At the same time, the incidence of myopia is somewhat higher than 10-15 years before. This increase is caused by two principal groups of factors: social and visual. The authors emphasize that the level of ophthalmologic care of the population in the Northern regions is to be improved and measures preventing diseases of the organ of vision be strictly adhered to.

Adult↗
PubMed1996

Use of care and subsequent mortality: the importance of gender.

OBJECTIVE: In light of recent discussions on access that have emphasized the need to relate access measures to outcomes, we examined the relationship between three self-reported utilization and access to care measures and the risk of subsequent mortality. DATA SOURCES AND DESIGN: A nationally representative sample from the first National Health and Nutrition Examination Survey that included adults 25-64 years of age without publicly funded health insurance was followed prospectively from initial interview in 1971 through 1975. DATA COLLECTION: Complete baseline and follow-up information was obtained on 4,491 persons (90 percent). Baseline access and use was assessed with answers to three questions: having a usual source of care, obtaining a general checkup, and not obtaining needed care (or forgone care). The relationships between the access and use measures and mortality by 1987 in men and women were examined using survival analyses. The analyses adjusted for race, and for baseline age, education, income, residence, insurance status, employment status, the presence of morbidity on examination, self-rated health, smoking status, leisure exercise, alcohol consumption, and obesity. PRINCIPAL FINDINGS: After adjusting for all other baseline variables, not obtaining a general checkup was associated with higher mortality in women (hazard ratio = 1.64 [95% confidence interval = 1.16, 2.32]), but not in men (hazard ratio = 1.07 [95% confidence interval = 0.80, 1.42]). Reporting a usual source of care and forgone care were not related to subsequent mortality in either women or men. CONCLUSIONS: Reporting a general checkup is an outcome-related utilization measure in women only. Further development of access and use indicators should address gender differences in health care use.

Adult↗
PubMedDate not supplied

Anemia severity and missed dialysis treatments in erythropoietin-treated hemodialysis patients.

Neither the sociodemographic correlates nor the biochemical/clinical consequences of missed dialysis treatments have been well defined. During a 10 week period, the authors enumerated missed dialysis treatments among 430 patients randomly selected from a pool of 1,395 hemodialysis patients. A forward logistic regression model was used to determine whether a relationship existed between missed dialysis treatments and the following independent variables: age, gender, race, renal diagnosis, length of time on maintenance hemodialysis, co-morbidity index, modified Karnofsky score, employment status, household residents, and laboratory indices. Forty-three (10%) of 430 patients missed a total of 96 treatments. Despite equivalent treatment with erythropoietin, patients who missed dialysis treatment(s) had a lower mean hematocrit (27 +/- 4.3%) at the end of the study than those patients who underwent all treatments (29 +/- 4.5%) (p = 0.0287). Mean serum albumin and creatinine levels were equivalent in compliant and noncompliant patients. Recent starts (p = 0.0048), and younger patients (p = 0.0424) were most likely to miss dialysis treatment(s). One of the major consequences of missed dialysis treatment(s) is exacerbation of anemia, and younger patients and freshly started patients are more likely to miss scheduled dialysis treatments than their respective counterparts.

Adult↗