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PubMed1999

Nutritional factors in human cancers.

A variety of external factors interacting with genetic susceptibility influence the carcinogenesis process. External factors including oxidative compounds, electrophilic agents, and chronic infections may enhance genetic damage. In addition, various hormonal factors which influence growth and differentiation are critically important in the carcinogenic process. Diet and nutrition can influence these processes directly in the gastrointestinal tract by providing bioactive compounds to specific tissues via the circulatory system, or by modulating hormone levels. Differences in certain dietary patterns among populations explain a substantial proportion of cancers of the colon, prostate and breast. These malignancies are largely influenced by a combination of factors related to diet and nutrition. Their causes are multifactorial and complex, but a major influence is the widespread availability of energy-dense, highly processed and refined foods that are also deplete in fiber. These dietary patterns in combination with physical inactivity contribute to obesity and metabolic consequences such as increased levels of IGF-1, insulin, estrogen, and possibly testosterone. These hormones tend to promote cellular growth. For prostate cancer, epidemiologic studies consistently show a positive association with high consumption of milk, dairy products, and meats. These dietary factors tend to decrease 1.25(OH)2 vitamin D, a cell differentiator, and low levels of this hormone may enhance prostate carcinogenesis. While the nutritional modulation of growth-enhancing and differentiating hormones is likely to contribute to the high prevalence of breast, colorectal, prostate, and several other cancers in the Western world, these cancers are relatively rare in less economically developed countries, where malignancies of the upper gastrointestinal tract are quite common. The major causes of upper gastrointestinal tract cancers are likely related to various food practices or preservation methods other than refrigeration, which increase mucosal exposure to irritants or carcinogens.

Antioxidants↗
PubMed1996

Psychosocial problems and adjustment of children with beta-thalassemia and their families.

This study explores the psychosocial problems experienced by families with children aged 6 to 14 years suffering from beta-thalassemia major (N = 188). The psychosocial problems and the family's adjustment to the effects of the illness were compared across a number of cultures where the disease is prevalent, namely Cyprus, Greece, and Italy. A small number of migrant children in the United Kingdom was also included in the study. Semi-structured interviews were conducted with parents who also completed the Rutter Parental Questionnaire and the Goldberg General Health Questionnaire. Teachers were asked to complete a Children's Behaviour Questionnaire designed by Rutter. In all countries the disease seemed to have a binding effect on the family, thus mobilizing adaptive mechanisms. Father's low education level and the presence of major medical complications were predictors of poor family adjustment. Differences between and within countries may well reflect differences in health policies, existing level of socio-economic development, and in the cultural patterns in coping with a chronic illness.

Adaptation, Psychological↗
PubMed1992

The future of neurosurgery.

Many factors influence the future of neurosurgery, among them the general growth of the world population with an increasing number of older persons and the political-economical development which differs markedly from region to region. Another important factor will be the biological and molecular revolution which has just begun and makes it likely, that some of the pathologies, which needed neurosurgical management, become accessible to conservative treatment in the future. Finally the neurosurgical sphere of activity is endangered by take-over tendencies of neighbouring medical specialties. Those of us who are in charge of neurosurgical organization and planning should take these and additional factors into consideration early enough, in order to give neurosurgery and neurosurgeons a chance to adapt to the future.

Developing Countries↗
PubMedDate not supplied

[Demography and medicine in Switzerland: medical manpower and project "DEMOMED"].

The situation as regards medical manpower in Switzerland in 1975 is characterized by high enrollment in the medical schools and a doubling time for the number of physicians in practice of approximately twenty years. A federal commission concerned with problems related to medical studies (CEPREM) conducted a study aiming at defining an optimum figure for intake of students into the medical schools. A survey of the international literature and a statistical study of availability of physician services region by region in Switzerland were conducted. The results show that it is impossible to define with precision an optimum "medical density" for Switzerland. The system of health and the functions of its various professions are not defined, and powers of decision in this field are not uniformly attributed. In the national survey, the most striking feature was disparity between various regions as regards access to medical or paramedical services. This disparity is parallel to state of economical development, and unlikely to be corrected even by an excess of overall medical manpower. Four hypotheses are presented on the consequences of increase, decrease, or stable enrolment in the medical schools. We conclude that there is no technical basis for defining an optimal medical density, but that it would be reasonable to decrease the number of second-year students by a factor of the order of 25% on the basis of a political decision.

Physicians↗
PubMed1998

Epidemiologic panorama of colorectal cancer in Mexico, 1980-1993.

INTRODUCTION: Colorectal cancer is the third cause of cancer-related death in the world, with 468,000 estimated deaths in 1993. In some countries mortality rates have started to decline, and survival rates have increased. In this study performed in Mexico, information is presented on the increase in mortality from this form of cancer, especially in more economically developed areas. METHODS: The mortality trend for colorectal cancer was evaluated and standardized by five-year age groups in the period 1980 to 1993. Also, the standardized mortality ratio was calculated for Mexico's 32 states, as was the possible association between mortality and indicators of rurality level and fertility rates in the different regions of Mexico. RESULTS: In the period studied, 18,962 deaths were officially reported. The average age of death was 66 years. The mortality rate among women (1.8) was significantly higher than among men (1.55 per 100,000 inhabitants). Mortality from colorectal cancer grew by 100 percent in both genders (beta = 0.089; P < 0.001), especially in the age group 34 and younger, in the 45 to 49 age group, and in the older than 75 age group (P < 0.05). The standardized mortality ratio was greater in the states in the north of Mexico. Finally, an inverse correlation was observed throughout Mexico between the rurality index (r = -0.60; P < 0.001) and the fertility rates (r = -0.43; P < 0.05) and mortality from colorectal cancer. CONCLUSIONS: In this study, there is evidence that mortality from this cancer is higher in geographic areas with greater socioeconomic development, similar to regional patterns observed in other countries. In Mexico, the coming years will see a serious epidemic in mortality from this disease; therefore, immediate attention must be given to identifying the profile of high-risk subjects and implementing early cancer detection measures.

Adolescent↗
PubMed1982

Mental health systems and services abroad.

A cross-national survey of forty-two countries and provinces was undertaken to compare mental health policies, mental health services, awareness of these services, the evaluation of such services and how mental health care is financed. Notable differences were found between respondents and these differences could not always be accounted for in terms of the level of the countries economic development. Discussions of trends are detailed and suggestions for future inquiry are proffered.

Data Collection↗
PubMedDate not supplied

Childhood cancer: improved prospects for survival but is prevention possible?

With optimum treatment 65-70% of children diagnosed with cancer should be long term survivors and probably cured. Prevention is better than cure. Recent studies into the causes of childhood malignancy are reviewed. The incidence of childhood acute lymphoblastic leukaemia (ALL) is steadily increasing. The cause for this may be increasing social and economic development. Exposure to electromagnetic fields has been a cause of concern for almost 20 years. A recent large case control study has shown no increased risk of cancer or leukaemia in those who have measurably increased exposure to electromagnetic fields. Leukaemia which has the cytogenetic abnormality 11q23 or MLL gene rearrangement characteristically occurs as a second malignancy after exposure to epipodophyllotoxins which act by inhibiting topoisomerase. Infant leukaemia has the same cytogenetic profile. Mothers of babies who develop infant leukaemia have high exposure to potential dietary inhibitors of topoisomerase during pregnancy. Clusters of leukaemia can probably best be accounted for by population mixing. There may be an increased risk of ALL following vitamin K given to newborns.

Causality↗
PubMedDate not supplied

Perinatal mortality in Ludhiana, Punjab--a seven year hospital study.

Perinatal deaths occurring over a seven year period were studied in a teaching hospital in Punjab. Causes of death were analysed as per Wigglesworth's classification. We have further modified this by correlating different gestations and weight groups with causes of death. The perinatal mortality rate (PNMR) in the present study was 74/1000 and showed a downward trend secondary to a statistically significant fall of early neonatal mortality. There was a decline in PNMR among babies of 1500-2000 g. birth weight and 33-36 weeks gestation. Asphyxia and macerated still births were found to be the two main causes of death. Macerated still births were seen more commonly among babies of lower weight at all gestations. The PNMR of babies born to booked mothers was 22/1000 as compared to 152/1000 among unbooked mothers. It was concluded that to bring down the PNMR, economic development alone is not enough. Provision of adequate antenatal care to all mothers, health education and timely referral of high risk mothers is very essential.

Asphyxia Neonatorum↗
PubMed2001

Forest ecosystems and the changing patterns of nitrogen input and acid deposition today and in the future based on a scenario.

A global assessment of the impact of the anthropogenic perturbation of the nitrogen and sulfur cycles on forest ecosystems is carried out for both the present-day [1980-1990] and for a projection into the future [2040-2050] under a scenario of economic development which represents a medium path of development according to expert guess [IPCC IS92a]. Results show that forest soils will receive considerably increasing loads of nitrogen and acid deposition and that deposition patterns are likely to change. The regions which are most prone to depletion of soils buffering capacity and supercritical nitrogen deposition are identified in the subtropical and tropical regions of South America and Southeast Asia apart from the well known 'hotspots' North-Eastern America and Central Europe. The forest areas likely to meet these two risks are still a minor fraction of the global forest ecosystems, though. But the bias between eutrophication and acidification will become greater and an enhanced growth triggered by the fertilizing effects of increasing nitrogen input cannot be balanced by the forest soils nutrient pools. Results show increasing loads into forest ecosystems which are likely to account for 46% higher acid loads and 36% higher nitrogen loads in relation to the 1980-1990 situation. Global background deposition of up to 5 kg N ha-1 a-1 will be exceeded at more than 25% of global forest ecosystems and at more than 50% of forest ecosystems on acid sensitive soils. More than 33% of forest ecosystems on acid sensitive soils will receive acid loads which exceeds their buffering capacity. About 25% of forest areas with exceeded acid loads will receive critical nitrogen loads.

Acid Rain↗
PubMed1993

Is demographic uniformity inevitable?

"Globalizing processes of industrialization and Westernization are creating a retreat from diversity in human experience. The paper discusses whether population trends are reinforcing this process and draws on findings about growth rates, the family and urbanization in Western countries, East and Southeast Asia and Latin America. The extent to which counterbalancing forces, including cultural resilience, are curbing homogenization is also examined."

Cross-Cultural Comparison↗