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Cumulative Exposure (cumulative + exposure)
Selected AbstractsCumulative adversity and drug dependence in young adults: racial/ethnic contrastsADDICTION, Issue 3 2003R. Jay Turner ABSTRACT Aims To study cumulative exposure to stressors as a risk factor for drug dependence, and evaluate whether group differences in exposure contribute to differences in prevalence. Design Cross-sectional community survey of life-time adverse experiences and substance and psychiatric disorders. Setting Data collected between 1997 and 2000 in Miami,Dade County, USA. Participants A total of 1803 former Miami,Dade public school students, 93% between ages 19 and 21 years when interviewed. Males and females of Cuban origin, other Caribbean basin Hispanics, African-Americans and non-Hispanic whites are represented equally. Measurements Drug dependence disorder assessed by DSM-IV criteria using the Composite International Diagnostic Interview, and a 41-item checklist of life-time exposure to major and potentially traumatic experiences. Both measures include age at time of first occurrence. Findings Life-time rate of drug dependence disorder (total 14.3%) did not vary significantly (P > 0.05) by socio-economic group. Male rate (17.6%) was significantly greater than female rate (10.9%). The African-American rate (6.5%) was dramatically lower than non-Hispanic white (17.0%), Cuban (18.1%) and non-Cuban Hispanic (16.0%) rates despite their dramatically higher exposure to adversity. Twenty-eight of 33 individual adversities were associated with the subsequent onset of drug dependence (P < 0.05). Cumulative life-time exposure was greatest for males and for African-Americans, and was associated inversely with socio-economic level. Multivariate discrete-time event history analysis revealed significant independent effects of distal (>1 year earlier) and proximal (previous year) exposure to adverse events (P < 0.05), controlling for childhood conduct disorder, attention deficit hyperactive disorder and previous psychiatric disorder. Conclusions Life-time cumulative exposure to distant as well as more recent adversity predicts risk of subsequent drug dependence, although it does not explain ethnic group differences in risk. [source] The effect of chronic benzodiazepine use on cognitive functioning in older persons: good, bad or indifferent?INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2007E. J. M. Bierman Abstract Objective This study investigates the effects of benzodiazepine (BZ) use on cognitive performance in elderly persons in a longitudinal design. Study design and setting Data were obtained from the Longitudinal Aging Study Amsterdam (LASA), in the Netherlands. 2,105 respondents (,62 years of age) were included and had repeated measurements over a period of 9 years. For all BZs the type, dosage, frequency and duration of use was measured. The equivalent of a dose of diazepam was determined with regard to type and dosage and a cumulative dosage was calculated. General cognitive functioning was measured with the Mini-Mental State Examination, information processing speed was measured with the coding task, fluid intelligence with Raven's Coloured Progressive Matrices and episodic memory with the Auditory Verbal Learning Test. Multilevel analyses were used to investigate the relationship between BZ use and cognitive decline. Results A negative effect of BZ use on cognitive performance was found. However, the effect sizes were very small. Conclusion This study suggests that both duration and cumulative exposure to BZ has a small negative effect on the long-term cognitive functioning of elderly people in the community. Copyright © 2007 John Wiley & Sons, Ltd. [source] Sense of coherence and its association with exposure to traumatic events, posttraumatic stress disorder, and depression in eastern Democratic Republic of Congo,JOURNAL OF TRAUMATIC STRESS, Issue 3 2010Phuong N. Pham The Democratic Republic of Congo is the scene of some of the worst atrocities in recent history. However, in the face of traumatic experience, only a minority of people develops symptoms that impair their functioning. The sense of coherence proposed by Antonovsky (1987) is a theoretical construct reflecting an individual's overall wellbeing and ability to cope with stress. This study explores the relationships between sense of coherence, exposure to traumatic events, symptoms of posttraumatic stress disorder (PTSD), and depression. Results suggest an association between a high sense of coherence and high education levels, high income, and positive social relationships. Furthermore, the study found that sense of coherence is inversely correlated with cumulative exposure to violence and symptoms of PTSD and depression. [source] Therapeutic management of recurrent hepatitis C after liver transplantationLIVER INTERNATIONAL, Issue 3 2007Rosāngela Teixeira Abstract Recurrent hepatitis C ranges from minimal damage to cirrhosis developing in a few months or years in a substantial proportion of transplant recipients. Different virus, host and donor factors are involved in the pathogenesis of recurrence, but many are poorly understood. Therapeutic strategies can be utilized in the pre-, peri- or posttransplantation setting. Antiviral therapy using interferon and ribavirin and modifying immunosuppression are the main strategies to prevent progression disease. The efficacy of interferon and ribavirin is limited and side effects, reduction/withdrawal are frequent. Current sustained virological response rates are approximately 28%. An optimal immunosupppression regimen has not been established. The choice of calcineurin inhibitors has not clearly been shown to affect histological hepatitis C virus (HCV) but higher cumulative exposure to corticosteroids to treat acute rejection is associated with more severe recurrence. The manner in which the doses of immunosuppression are modified has more influence on HCV recurrence than the use of a specific drug per se. Debate about the influence of immunosuppressive regimens on HCV recurrence is ongoing. Potential antifibrotic therapy and new agents targeting HCV infection and replication are emerging and are anticipated to be added to our armentarium in battling recurrent HCV post-LT. [source] The hepatotoxicity of non-steroidal anti-inflammatory drugsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 4 2004J. H. Rubenstein Summary Background :,Non-steroidal anti-inflammatory drugs have been implicated in reports of liver injury. However, the precise risk of non-steroidal anti-inflammatory drugs for this rare complication is unknown. Aim :,To review systematically the published literature of population-based epidemiological studies reporting the incidence or comparative risk of non-steroidal anti-inflammatory drugs for liver injury resulting in clinically significant events, defined as hospitalization or death. Data extraction :,Duplicate extraction of the methodological quality, design, source, population, years studied, particular non-steroidal anti-inflammatory drugs studied, definitions, patient counts and follow-up, and the adjustment for confounders. Results :,Seven articles met inclusion criteria. The comparative risk of liver injury resulting in hospitalization for current non-steroidal anti-inflammatory drug users compared with past non-steroidal anti-inflammatory drug users ranged from 1.2 to 1.7, but none was statistically significant. The incidence of liver injury resulting in hospitalization ranged from 3.1 to 23.4/100 000 patient-years of current use of non-steroidal anti-inflammatory drugs, with an excess risk compared with past non-steroidal anti-inflammatory drugs users of 4.8,8.6/100 000 patient-years of exposure. There were zero deaths from liver injury associated with non-steroidal anti-inflammatory drugs use in over 396 392 patient-years of cumulative exposure. Conclusion :,These findings allow for the possibility of a small increase in the risk of clinically relevant hepatotoxicity with non-steroidal anti-inflammatory drugs use, but do not document that such a risk occurs. [source] Carbon black and lung cancer,testing a novel exposure metric by multi-model inferenceAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 11 2009Peter Morfeld PhD Abstract Background In a recent analysis of a UK cohort Sorahan and Harrington [2007: Am J Ind Med 50: 555,564] assessed the most recent 15 years of exposure ("lugging") to support their hypothesis that carbon black acts as a late stage lung carcinogen. We tested this metric in a German cohort of 1,528 carbon black workers. Methods We used a multi-model Cox regression approach (720 models) to explore the impact of duration and cumulative exposure to carbon black "lugged" by 0, 5, 10, 15, and 20 years. This approach covered four sub-cohorts, including an inception cohort, different exposure scenarios and varying combinations of confounders. Results Seven hundred nineteen models returned negative coefficients. Only one model estimated a small positive, but clearly non-significant coefficient (P,=,0.8). Conclusions Despite extensive searching, no exposure scenario suggested an adverse effect of "lugged" carbon black exposure on lung cancer mortality. Our analysis does not support the hypothesis of carbon black being a late stage carcinogen. Am. J. Ind. Med. 52:890,899, 2009. © 2009 Wiley-Liss, Inc. [source] Bone manganese as a biomarker of manganese exposure: A feasibility studyAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 10 2009-Mili, Ana Pejovi Abstract Background There is a need for a diagnostic tool with the ability to measure cumulative exposure to manganese (Mn) in the workplace. Measuring bone Mn levels with in vivo neutron activation analysis (IVNAA) could serve as a biomarker of past exposure. Bone Mn levels of welders were measured and compared to the levels found in subjects without exposure to the element. Method Forty subjects (30 welders and 10 controls) were recruited. An occupational history was obtained and subjects underwent IVNAA bone Mn measurements. Results The mean bone Mn levels were (2.9,±,0.4) and (0.1,±,0.7),µg Mn/g Ca for welders and controls, respectively (P,<,0.05). Conclusions This project, the first of its kind, reports differences in bone Mn between Mn-exposed welders and non-occupationally exposed subjects. It appears that bone Mn levels do reflect differences in the occupational exposure of welders. Am. J. Ind. Med. 52:742,750, 2009. © 2009 Wiley-Liss, Inc. [source] Asbestos exposure and benign asbestos diseases in 772 formerly exposed workers: Dose,response relationshipsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 8 2009Giuseppe Mastrangelo MD Abstract Background Since previous studies have provided conflicting results, we investigated the relationship between the risk of benign asbestos-related diseases and different aspects of asbestos exposure in previous asbestos workers who underwent low-dose computed tomography (CT). Methods CT scans were carried out in 772 subjects. A questionnaire was employed to collect data on smoking habits and duration, peak and cumulative exposure, and time since first exposure to asbestos. Multiple logistic regression models with stepwise selection of variables were used to evaluate the associations. Results Fourteen (1.8%) cases of asbestosis, 187 (24.2%) of pleural plaques (PP), and 50 (6.5%) of diffuse pleural thickening (DPT) were found. The significant risk factors were: cumulative exposure for asbestosis (P for trend,=,0.004); time since first exposure (P for trend <0.001), and peak exposure (P for trend <0.001) for PP; and time since first exposure for DPT (P for trend,=,0.024). Conclusions Parenchymal asbestosis and PP are associated with different aspects of asbestos exposure. DPT appears to be less specific for asbestos exposure. Am. J. Ind. Med. 52:596,602, 2009. © 2009 Wiley-Liss, Inc. [source] Morbidity in former sawmill workers exposed to pentachlorophenol (PCP): A cross-sectional study in New ZealandAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 4 2009David McLean PhD Abstract Background From 1950 to 1990 pentachlorophenol (PCP) was used widely in the New Zealand sawmill industry, and persistent claims of long-term health effects have been made. Methods We surveyed surviving members of a cohort enumerated to study mortality in sawmill workers employed from 1970 to 1990. Estimates of historical exposure were based on job titles held, using the results of a PCP biomonitoring survey conducted in the 1980s. The survey involved interviews and clinical examinations, with interviewers and examiners blinded to exposure status. Results Of the 293 participants 177 had not been exposed, and of the 116 exposed all but 10% had low or short-term PCP exposure. Nevertheless, a number of significant associations between PCP exposure and the prevalence of various symptoms were observed including associations between: (i) exposure levels and self-reported tuberculosis, pleurisy or pneumonia (P,<,0.01) and a deficit in cranial nerve function (P,=,0.04); (ii) duration of employment and thyroid disorders (P,=,0.04), and neuropsychological symptoms including often going back to check things (P,=,0.04), low libido (P,=,0.02) and heart palpitations (P,=,0.02), and a strong dose,response trend for frequent mood changes without cause (P,<,0.01); and (iii) cumulative exposure and frequent mood changes without cause (P,=,0.02), low libido (P,=,0.04), and in the overall number of neuropsychological symptoms reported (P,=,0.03). Conclusions PCP exposure was associated with a number of physical and neuropsychological health effects that persisted long after exposure had ceased. Am. J. Ind. Med. 52:271,281, 2009. © 2009 Wiley-Liss, Inc. [source] A new electromagnetic exposure metric: High frequency voltage transients associated with increased cancer incidence in teachers in a california schoolAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 8 2008Samuel Milham MD Abstract Background In 2003 the teachers at La Quinta, California middle school complained that they had more cancers than would be expected. A consultant for the school district denied that there was a problem. Objectives To investigate the cancer incidence in the teachers, and its cause. Method We conducted a retrospective study of cancer incidence in the teachers' cohort in relationship to the school's electrical environment. Results Sixteen school teachers in a cohort of 137 teachers hired in 1988 through 2005 were diagnosed with 18 cancers. The observed to expected (O/E) risk ratio for all cancers was 2.78 (P,=,0.000098), while the O/E risk ratio for malignant melanoma was 9.8 (P,=,0.0008). Thyroid cancer had a risk ratio of 13.3 (P,=,0.0098), and uterine cancer had a risk ratio of 9.2 (P,=,0.019). Sixty Hertz magnetic fields showed no association with cancer incidence. A new exposure metric, high frequency voltage transients, did show a positive correlation to cancer incidence. A cohort cancer incidence analysis of the teacher population showed a positive trend (P,=,7.1,×,10,10) of increasing cancer risk with increasing cumulative exposure to high frequency voltage transients on the classroom's electrical wiring measured with a Graham/Stetzer (G/S) meter. The attributable risk of cancer associated with this exposure was 64%. A single year of employment at this school increased a teacher's cancer risk by 21%. Conclusion The cancer incidence in the teachers at this school is unusually high and is strongly associated with high frequency voltage transients, which may be a universal carcinogen, similar to ionizing radiation. Am. J. Ind. Med. 51:579,586, 2008. © 2008 Wiley-Liss, Inc. [source] Effects of theatrical smokes and fogs on respiratory health in the entertainment industryAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2005Sunil Varughese MSc Abstract Background Theatrical fogs (glycol or mineral oil aerosols) are widely used in the entertainment industry to create special effects and make lighting visible. Methods We studied 101 employees at 19 sites using fogs and measured personal fog exposures, across work shift lung function, and acute and chronic symptoms. Results were also compared to an external control population, studied previously. Results Chronic work-related wheezing and chest tightness were significantly associated with increased cumulative exposure to fogs (mineral oil and glycols) over the previous 2 years. Acute cough and dry throat were associated with acute exposure to glycol-based fogs; increased acute upper airway symptoms were associated with increased fog aerosol overall. Lung function was significantly lower among those working closest to the fog source. Conclusions Mineral oil- and glycol-based fogs are associated with acute and chronic adverse effects on respiratory health among employees. Reducing exposure, through controls, substitution, and elimination where possible, is likely to reduce these effects. Am. J. Ind. Med. 47:411,418, 2005. © 2005 Wiley-Liss, Inc. [source] Vibration exposure and disease in a shipyard: A 13-year revisitAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 6 2004Martin Cherniack MD Abstract Background In a 1988 study of shipyard workers, a progressive association was observed between cumulative exposure to vibration and the vascular and neurological symptoms of the hand-arm vibration syndrome (HAVS). In 2001, after a decade of exposure reduction and ageing of the workforce, a second study at the same site was initiated. Methods In 2001, 214 subjects were selected; they represented four current weekly vibration exposure time intervals,0 hr, >0,<,5 hr, ,5,<,20 hr, ,20 hr. The 1988 and 2000 cross-sectional populations were compared on the basis of exposure duration and current symptoms. Results In 2001, the study population was 9.6 years older than the 1988 group. Current weekly exposure hours were similar in the low and medium exposure groups 2001 and 1988, but exposure was reduced by an average of 9.7 hr per week in the highest exposure group (,20 hr) in 2001. Symptom severity was regressed polychotomously on estimated exposure (log cumulative hours); the OR was weaker in 2001 than in 1988 for sensorineural symptoms,1.44 [CI 1.04,1.98] versus 2.35 [CI 1.48,3.73]. This was also true for vascular symptoms,1.70 [CI 1.06,2.71] versus 3.99 [CI 2.27,7.01]. Vascular symptoms were more prevalent in the highest lifetime vibration exposure group in 1988 (68.7 vs. 43.2% in 2001); sensorineural symptoms were more prevalent in the least vibration exposed group in 2001 (52.6 vs. 20.7% in 1988). Conclusions The prevalence of vascular symptoms associated with cumulative vibratory exposure was significantly greater in 1988, but neurological symptoms were more common at lower exposure levels in 2001. The presumption that reducing exposure duration alone is sufficient, in the absence of change in vibration magnitude, is not supported by the results of this study. Am. J. Ind. Med. 45:500,512, 2004. © 2004 Wiley-Liss, Inc. [source] Quantitative exposure-response for silica dust and lung cancer in Vermont granite workers,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 2 2004Michael D. Attfield BSc Abstract Background Excess lung cancer mortality among the exposed Vermont granite workers has been reported. These studies were based on job and tenure surrogates, with the potential for misclassification and inability to evaluate quantitative exposure-response. Methods Industrial hygiene data collected from 1924 to 1977 was analyzed in conjunction with mortality data to examine quantitative exposure-response for silica, lung cancer, and other lung diseases. A person-years analysis was undertaken by cumulative exposure group, including lagged and unlagged tabulations. Poisson models were fitted to untransformed and log transformed exposure. Results The results indicated a clear relationship of lung cancer, tuberculosis, pneumoconiosis, non-malignant lung disease, and kidney cancer with cumulative exposure. An exposure to 0.05 mg/m3 from age 20 to 64 was associated with a lifetime excess risk of lung cancer for white males of 27/1,000. Conclusions The results of this study of workers exposed almost exclusively to silica and no other major occupational confounding exposures indicate a clear exposure-response for lung cancer. Am. J. Ind. Med. 45:129,138, 2004. Published 2004 Wiley-Liss, Inc. [source] Predictors of shoulder and back injuries in nursing home workers: A prospective studyAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 6 2002Douglas Myers MA Abstract Background Nursing assistants (NAs) working in nursing homes have among the highest back and shoulder injury rates in the US. Incidence, severity, and cost of non-traumatic soft tissue musculoskeletal disorders in the nursing home industry in Washington State are quite high. Methods To determine whether resident characteristics data reported on the Health Care Financing Administration Minimum Data Set (MDS) could be used as a surrogate measure of cumulative exposure to physical loads, we conducted an 18-month prospective study in one nursing home. Results The combined NA injury incidence rate (IR) was 45.8 self-reported back and shoulder injuries per 100 [FTE] workers per year. In general, MDS reported resident characteristics failed to predict risk with the exception of exposure to loss of voluntary leg mobility (OR,=,1.11 per person-shifts of exposure, 95% CI [0.97,1.27]), with the highest risk on the day shift (OR,=,1.15, 95% CI [0.95,1.40]). Conclusions These findings suggest social integration and work organization issues may be more important predictors of back and shoulder injuries in nursing assistants than reported resident characteristics as measured by the MDS. Am. J. Ind. Med. 41:466,476, 2002. © 2002 Wiley-Liss, Inc. [source] Non-malignant asbestos-related diseases in Brazilian asbestos-cement workersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2001E. Algranti MD Abstract Background Production of asbestos-cement products in Brazil started in the 1940s, peaked in the 60,70s and is still an active industry. This study was designed to assess the non-malignant effects of asbestos exposure in the asbestos-cement industry in Brazil. Methods A group of 828 former asbestos-cement workers enrolled in a cross-sectional and cohort study of respiratory morbidity, submitted to a detailed occupational history, respiratory symptoms questionnaire, spirometry, PA chest x-ray, and high resolution computed chest tomography (HRCT). Asbestos exposure was assessed by years of exposure, cumulative exposure (a semi-quantitative method), and latency time from first exposure. Asbestosis and pleural thickening were assessed according to HRCT criteria. Results Asbestosis was present in 74 (8.9%) and pleural thickening in 246 (29.7%). Using the HRCT as the "best available evidence", it was shown that were more false negatives than false positives in the x-ray readings for parenchymal (21.6% false negatives, 4.2% false positives) and pleural (26.0% false negatives, 14.4% false positives) diseases due to asbestos. Latency time from first exposure was the best predictor for both asbestosis and pleural thickening. Subjects in the higher exposure groups presented lower levels of lung function. Obstructive defects were significantly related to smoking, shortness of breath, body mass index, and age, whereas restrictive defects were related to asbestosis, shortness of breath, and latency time. Chronic bronchitis increased with latency time in the three smoking groups and was significantly related to pleural thickening (OR 1.56 (1.00,2.42)). Shortness of breath was significantly associated with body mass index and pleural thickening (OR 1.30 (1.24,2.09)). Conclusions Pleural thickening and asbestosis showed a significant association with latency time and exposure. FVC and FEV1 decreased across increasing profusion with an added effect of pleural thickening. There was a significant and independent effect of exposure on lower levels of FVC and FEV1. Obstructive defects were mainly related to smoking and restriction to asbestosis. Dust exposure and smoking were synergistic in increasing chronic bronchitis and shortness of breath report. Shortness of breath report was also related to pleural thickening and higher body mass index. Am. J. Ind. Med. 40:240,254, 2001. © 2001 Wiley-Liss, Inc. [source] Childbearing and Women's Survival: New Evidence from Rural BangladeshPOPULATION AND DEVELOPMENT REVIEW, Issue 3 2003Jane Menken Effects of childbearing on women's mortality and the implications of family planning programs in reducing these effects are examined in a 20-year prospective study of more than 2,000 women in Matlab, Bangladesh. Maternal mortality is defined as a death occurring in the six weeks after childbirth. But childbearing may affect women's survival beyond this brief period. Additional hypotheses considered relate to 1) cumulative exposure to childbearing, whether measured by parity or pace of childbearing, 2) age at first birth, and 3) effects beyond the reproductive ages. The results offer no support to cumulative exposure hypotheses, showing no link between parity or pace of childbearing and mortality risk. Instead, we identify an extended period of heightened mortality risk associated with each birth,the year of the birth and the two subsequent years. Family planning programs, by reducing the number of children and therefore a woman's exposure to extended maternal mortality risk, potentially increase survival. Research is needed to identify and address the specific causes of extended maternal mortality risk so that appropriate ameliorative programs may be developed. [source] Glucocorticoids and cardiovascular events in rheumatoid arthritis: A population-based cohort studyARTHRITIS & RHEUMATISM, Issue 3 2007John M. Davis III Objective To determine the relationship between glucocorticoid exposure and cardiovascular (CV) events in patients with rheumatoid arthritis (RA). Methods A total of 603 adult residents of Rochester, Minnesota with incident RA between 1955 and 1995 were followed up through their medical records for a median of 13 years (total of 9,066 person-years). Glucocorticoid exposure was defined 3 ways: tertiles of cumulative exposure; recent use (,3 months) versus past use (>3 months); and average daily dosage (,7.5 mg/day or >7.5 mg/day). CV events, including myocardial infarction, heart failure, and death from CV causes, were defined according to validated criteria. Cox regression models were adjusted for demographic features, CV risk factors, and RA characteristics. Results Rheumatoid factor (RF),negative patients with exposure to glucocorticoids were not at increased risk of CV events, irrespective of the glucocorticoid dosage or timing of use, as compared with the reference group of RF-negative patients who had never been exposed to glucocorticoids. In contrast, RF-positive patients were at increased risk of CV events, particularly with higher cumulative exposure, higher average daily dosage, and recent use of glucocorticoids. RF-positive patients with high cumulative exposure to glucocorticoids had a 3-fold increased risk of CV events (hazard ratio 3.06 [95% confidence interval 1.81,5.18]), whereas RF-negative patients with high cumulative exposure were not at increased risk (hazard ratio 0.85 [95% confidence interval 0.39,1.87]). Conclusion RF-positive but not RF-negative patients were at increased risk of CV events following exposure to glucocorticoids. These findings suggest that glucocorticoids interact with RF status to modulate the occurrence of CV events in patients with RA. The mechanisms underlying this interaction are unknown and should be the subject of further research. [source] Multiple senile lentigos of the face, a skin ageing pattern resulting from a life excess of intermittent sun exposure in dark-skinned caucasians: a case,control studyBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2006S. Monestier Summary Background, Different patterns of skin ageing can be described depending on the predominant lesions, i.e. wrinkles, laxity, atrophy, senile lentigos (SLs), etc. They may correspond to different epidemiological contexts. Objectives, To identify and assess the epidemiological factors for a skin ageing pattern characterized by a high density of SLs on the face, or ,lentigo ageing pattern' (LAP). Methods, An age- and sex-matched case,control study was conducted in individuals aged between 60 and 80 years, comparing cases (n = 118) with a very high number of SLs on the face for their age, and controls (n = 118) with no or very few SLs for their age. The cases and controls were recruited in two hospitals. Results, In univariate and multivariate analysis, LAP was associated with skin types III and IV, with frequent sunburns, and with the part of the lifetime cumulative sun exposure which was received during vacations. Conversely, there was no link with the occupational and everyday exposures and the total cumulative exposure. LAP was associated with multiple solar lentigos of the upper back. No relationship was found with postmenopausal hormonal therapy, number of naevi, or freckles. Conclusions, Different epidemiological factors may account for the different skin ageing patterns. LAP seems to develop preferentially in dark-skinned caucasians who have repeatedly received intermittent and intense sun irradiations throughout their life, and have often developed solar lentigos on the upper back earlier in life, whereas the ,prominent wrinkling' pattern is known to affect light-skinned people and smokers with a life excess of continuous exposure. [source] The relationship between breast density and bone mineral density in postmenopausal womenCANCER, Issue 9 2004Diana S. M. Buist Ph.D., M.P.H. Abstract BACKGROUND It is not well understood whether breast density is a marker of cumulative exposure to estrogen or a marker of recent exposure to estrogen. The authors examined the relationship between bone mineral density (BMD; a marker of lifetime estrogen exposure) and breast density. METHODS The authors conducted a cross-sectional analysis among 1800 postmenopausal women , 54 years. BMD data were taken from two population-based studies conducted in 1992,1993 (n = 1055) and in 1998,1999 (n = 753). The authors linked BMD data with breast density information collected as part of a mammography screening program. They used linear regression to evaluate the density relationship, adjusted for age, hormone therapy use, body mass index (BMI), and reproductive covariates. RESULTS There was a small but significant negative association between BMD and breast density. The negative correlation between density measures was not explained by hormone therapy or age, and BMI was the only covariate that notably influenced the relationship. Stratification by BMI only revealed the negative correlation between bone and breast densities in women with normal BMI. There was no relationship in overweight or obese women. The same relationship was seen for all women who had never used hormone therapy, but it was not significant once stratified by BMI. CONCLUSIONS BMD and breast density were not positively associated although both are independently associated with estrogen exposure. It is likely that unique organ responses obscure the relationship between the two as indicators of cumulative estrogen exposure. Cancer 2004. © 2004 American Cancer Society. [source] Follow-up of 5- to 11-year-old children treated for persistent pulmonary hypertension of the newbornACTA PAEDIATRICA, Issue 2 2009Vibeke Eriksen Abstract Aim: Determine the prevalence of sensorineural hearing loss (SNHL) and relate this to cumulative exposure to hypoxia, hypocapnia and hypotension. Describe chronic health problems among 5- to 11-year-old children treated for persistent pulmonary hypertension of the newborn (PPHN). Methods: The index group consisted of 85 children and a reference group was matched for age, sex and municipality of current residence. Questionnaires were sent to the families. The families in the index group were asked to participate in an examination of their child's hearing. Results: Seven children (11%) had SNHL. SNHL was not associated with hypoxia, hypocapnia or hypotension during treatment for PPHN. In the index group chronic health problems were reported in 42% compared with 17% in the reference group (chi-square test, p = 0.001). Twenty-one percent in the index group were treated with bronchodilator therapy compared with 8% in the reference group (chi-square test, p = 0.028). In the index group five children had cerebral palsy and two had developmental delay. Nineteen percent in the index group and 5% in the reference group had remedial education (chi-square test, p = 0.008). Conclusion: Children treated for PPHN are at high risk for SNHL. Exposure to hypoxia, hypocapnia or hypotension did not predict SNHL. The incidence of chronic health problems and use of remedial education was high. [source] | |||||||||||||