Obesity and cancer risk: a Danish record-linkage study

A cohort of 43,965 obese persons was accrued on the basis of discharge registrations from Danish hospitals, and incidence of cancer in the cohort was compared to that in the Danish population as a whole using indirect standardisation for age and period. Increased incidence was observed for cancer of the uterine corpus independently of age [114 cases, relative risk (RR) = 2.0, confidence interval 1.6-2.4], and for breast cancer in women above the age of 70 (133 cases, RR = 1.2). These findings are consistent with previous studies. In younger women, breast cancer occurred less frequently and ovarian cancer occurred more frequently than expected. Increased incidence was observed for cancers of the oesophagus (26 cases, RR = 1.9) and the liver (58 cases, RR = 1.9), probably reflecting an increased prevalence of excessive alcohol consumption in the cohort. Increased incidence was furthermore observed for cancers of the pancreas (101 cases, RR = 1.7), the prostate (96 cases, RR = 1.3) and the colon (195 cases, RR = 1.2), which may indicate the existence of risk factors which are common to obesity and to these cancers, for example, dietary habits. Kidney cancer was increased in women only. Overall, the incidence of cancer was increased by 16% in the cohort. The results were essentially unchanged by restriction to the subcohort of 8207 persons in whom obesity was the primary discharge diagnosis, and were also similar in the first year of follow-up after hospital discharge. Selection bias is, therefore, not likely to have influenced the results.     

Iowa wrestling study: weight classification systems

Serum vitamin E and cholesterol levels were determined for the residents in rural regions of Yamagata Prefecture, Japan. The average serum vitamin E were 0.99 +/- 0.25 mg/100ml in 166 men, and 1.06 +/- 0.26 mg/100ml in 178 women. Only 0.6% of the subjects were below 0.5 mg/100 ml. There was a significant difference between the serum vitamin E levels of men and women. However there were no statistically significant differences among serum vitamin E of various age groups. The best correlation for serum vitamin E was found with serum cholesterol.     

Early death in dialysis patients: risk factors and impact on incidence and mortality rates

Patients who die within the first 90 days after beginning dialysis are not included in mortality rates and may be absent from incidence counts. To identify factors associated with mortality within 3 months of the initiation of dialysis for ESRD and to estimate the impact of early deaths on ESRD incidence and mortality rates, this study investigated 15,245 patients who began dialysis in Georgia, North Carolina, and South Carolina over a 5-yr period. Data were collected by dialysis facility staff and reported to an ESRD registry. Six percent of all new patients died within 90 days of dialysis initiation (32% of all deaths occurring in the first year of treatment). Characteristics independently associated with increased risk of early death included older age, white race, male gender, physical and nutritional impairment, smoking, and the presence of cancer, congestive heart failure, clinical depression, and history of myocardial infarction. Depending on race-gender group, age-adjusted mortality rates based on this cohort were underestimated by 3 to 12% when patients who died early were excluded. These results suggest that certain patient characteristics-some potentially modifiable-confer increased risk of early death, and that the systematic exclusion of patients who die early from the U.S. national registry substantially influences ESRD mortality rates.     

A record-linkage study on risk factors for cause-specific infant mortality

Infant death certificates were linked with birth certificates for infants born to residents of Tohoku, Tokai and Kyushu regions in 1989 (n = 409, 679, or about one-third of all births in Japan), to examine the effects of variables, as reported on birth certificates, on cause-specific infant mortality. "Certain conditions originating in the perinatal period" and "congenital anomalies" accounted for nearly 90 percent of neonatal deaths, while "congenital anomalies", "injuries and poisoning" and "sudden infant death" were responsible for about 65 percent of postneonatal deaths. Mortality rates for almost all causes of infant deaths, except injuries and poisonings, increased as birth weight decreased not only in the neonatal period but also in the postneonatal period. This suggests that low birth weight places some infants at higher risk of death, and conditions that lead to low birth weight independently contribute to the risk of infant death. Cox's proportional hazards linear model was used to assess the effects of variables on infant mortalities by causes of death. An extremely strong birth weight effect was noted for "certain conditions originating in the perinatal period" and "congenital anomalies". Being a male infant and late order of birth in multiparity were other risk factors for deaths from "congenital anomalies", while being a male infant, resident of Tohoku region and maternal stillbirth experience related to deaths from "certain conditions originating in the perinatal period". Elevated risks of sudden infant death syndrome (SIDS), of which mortality rate in Japan was considerably lower than those in most developed Western countries, i.e. 0.23 per 1,000 live births in 1989, were associated with low birth weight, being a male infant, low maternal age, late order of birth in multiparity and illegitimacy. Low maternal age, late order of birth in multiparity and illegitimacy, also, related significantly to increased risk of infant deaths for "injuries and poisoning". These results suggest the independent contributions of socioeconomic factors to infant mortality, especially postneonatal mortality, from SIDS, "injuries and poisonings".     

Unexpected death of psychiatric patients: suicide, misadventure, accident or unsolved mystery?

BACKGROUND: Because of the wide range of recommended threshold values for carotid stenosis graduation we performed a prospective study to determine interobserver and interequipment variability of quantitative blood flow velocity measurements. PATIENTS AND METHODS: We recorded absolute blood flow velocities and velocity ratios in 21 patients with carotid artery stenosis using two colour coded duplex ultrasound systems an ATL Ultramark 9 HDI, and a Hewlett Packard SONOS 2500 system. The ATL system was used for the interobserver variation study, where each patient was examined twice on the same day. The Doppler angle was recorded together with blood flow velocities (peak systolic velocity and mean maximum velocity from the velocity-time-integral both in the stenosis jet and 4-5 cm distally in the cranial portion of the internal carotid artery off poststenotic turbulences). RESULTS: The ATL system generated significantly higher blood flow velocity values as compared with the HP system (218 +/- 156 cm/s vs. 169 +/- 114 cm/s; p < 0.001). The Mean Velocity Ratio (the ratio of intrastenotic Vmean and poststenotic Vmean) was constant with both duplex systems. The HP system yielded 10% (Cl, 7-13%) lower predicted stenosis estimates than the ATL system with Vmax as the stenosis criterion. The stenosis estimates calculated from Mean Velocity Ratio values did not differ significantly. The 95% Cl for predicted diameter reduction between two observer was 13.6% (Vmax) and 15.4% (Mean Velocity Ratio). CONCLUSION: Because of significant interequipment differences of colour coded duplex ultrasound systems we recommend calculation of the Mean Velocity Ratio to avoid interpatient and interequipment variation of absolute flow velocities. According to our interobserver variability study, a change of more than 15% diameter reduction on follow-up examinations indicates disease progression or regression.     

Method to study anhedonia in hospitalized psychiatric patients.

Loss of the ability to experience or anticipate pleasure is characteristic of depressive disorders. It plays a central role in psychosocial theories of depression that relate the etiology of depression to a poverty of positive reinforcement from the social and nonsocial environment. This experiment studied the voluntary utilization of putative pleasurable activities in hospitalized psychiatric patients. A computer-based selection of motor-skills, cognitive, and chance games was available to 73 inpatients on a 24-hour/day, 7-day/week schedule. Patients had the following diagnoses: Unipolar Depressed (n?=?25), Delusional Depressed (n?=?9), Secondary Depressed (n?=?10), Bipolar (n?=?12, Schizophrenic (n?=?5), and Other (n?=?12). Patients were studied over the course of their hospitalization with regard to self-rated mood, game and difficulty selection, expectancy of success, and actual game scores. A total of 7,744 games were voluntarily played by the patients. Analyses revealed that different diagnostic groups engaged in the games differently, showing "styles" of play that suggest personality-motivated differences in the use of pleasurable activities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Urbanisation and psychiatric admission rates in The Netherlands

This article discusses the possible links between urbanisation, demographic variables and psychiatric admission rates. Inpatient psychiatric admission rates were determined for the 647 Dutch municipalities. Then urbanisation was determined using 'area address density', a unit of measurement developed by the Dutch Central Statistical Office. Five degrees of urbanisation are distinguished. Twenty-nine demographic variables which might have a theoretical link with admission rates were collated for all municipalities. The results show that standardised total admission rates increase with urbanisation. The mean admission rate for the least urbanised municipalities is 2.02 per 1000 resident population, the rate for the most urbanised municipalities is 3.72 per 1000. It was then found that the prevalence of demographic risk factors increased with urbanicity. At the same time, it was found that almost all demographic variables correlated with admission rates. A multiple regression mode--which accounts for 22% of variance--shows that income distribution, address density and mortality all contribute significantly to the variance in admission rates for the 647 Dutch municipalities.     

Why patients fail to attend psychiatric outpatient follow-up: a pilot study

BACKGROUND/AIM: Traditionally, orthotopic liver transplantation has consisted of a total native hepatectomy that included retrohepatic inferior vena cava. The so-called "piggyback" technique was described by Tzakis et al. (2). It consists of a recipient hepatectomy with preservation of the native retrohepatic IVC and subsequent anastomosis of the homograft suprahepatic IVC to a cuff fashioned from the recipient's suprahepatic veins. In this study, a single surgeon's experience with both techniques during the same period of time is discussed to analyze any significant differences in survival, intraoperative blood loss, length of stay in the ICU, and total length of stay in the hospital. MATERIALS AND METHODS: Over a three year period, 128 patients were transplanted at the University of Pittsburgh. Of these, 66 patients (51.6%) had a piggyback (PB) operation while the remaining 62 (48.4%) had a "standard" (ST) operation. RESULTS: The actual 6 month survival was 81.8% in the PB group (54/66) and 74.2% in the ST group (46/62), with no statistical difference between the two. The median intraoperative blood usage was 6 units for the PB group versus 10 units for the ST group (p > 0.02). The median ICU length of stay was the same at 4 days, as was the total hospitalization duration, 21 days. The in-hospital deaths were included in the analysis. CONCLUSIONS: The piggyback technique has some advantages, including less bleeding and absence of brachial plexus or phrenic nerve injury. Several other important considerations are discussed. In conclusion, the results with the piggyback technique are equivalent to those obtained with the standard approach.     

Prediction of improvement in coping pathology in hospitalized psychiatric patients: A replication study.

Conducted a replication of a study by the authors (see record 1973-21504-001) on the prediction of modifications in coping pathology during psychiatric hospitalization. 65 patients were assessed at the time of admission and again at discharge by multiple Os. The battery of 7 predictor scales used measured concepts of premorbid adjustment (expressed both positively and negatively as ego strength and previous history of failure), level of manifest distress at intake, and negative expectations regarding psychotherapy. The multiple correlation found was .57 (p     

Daydreaming and symptom patterns of psychiatric patients: A factor analytic study.

Studied the daydream activity of psychiatric patients, particularly the relation between symptom patterns and daydreaming styles. 113 male psychiatric patients responded to a daydream questionnaire derived from the Imaginal Processes Inventory. Interviewers rated patients on the presence and severity of hallucinations, delusions, anxiety, depression, and other symptoms. Little relation was evidenced, in general, between daydream styles and particular symptom pictures. Patients with psychotic symptomatology could not be distinguished from others on the basis of daydream style. Relations were observed, however, between daydreaming subscales and ratings of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confluent paranoia in African American psychiatric patients: An empirical study of Ridley's typology.

This study examined C. R. Ridley's (1984) typology of paranoia in African Americans, which assumes orthogonal dimensions of culture and pathology in symptom expression. Median split of scores on the Cultural Mistrust Inventory and the scale of False Beliefs and Perceptions represented high and low levels of cultural paranoia and pathological paranoia, respectively. The 4 groups of Black patients were nonparanoia, cultural paranoia, pathological paranoia, and confluent paranoia. A Fenigstein Paranoia Scale manipulation check indicated that differences in paranoid symptom expression among the groups were partially supportive of Ridley's model, as were measures of perceptions of hostility and self-esteem. Omnibus tests of between-groups differences were significant for global assessment of functioning and number of symptoms recorded in patients' charts. Predicted pattern testing revealed a significant severity dimension in mean scores across paranoia groups for some measures of clinician-rated functioning but not others. SCID interviewers' ratings of cultural mistrust and number of times restrained (or secluded) were more consistent with a pattern representing a cultural dimension than a severity dimension across paranoia groups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Immunoglobulin levels in psychiatric patients

In a study of 19 schizophrenic patients, 7 nonschizophrenic patients, and 31 controls, the authors found significantly higher mean serum levels of 1) immunoglobulin A in schizophrenic women then in control women and in schizophrenic blacks than in either schizophrenic whites or black controls. 2) immunoglobulin D in schizophrenic blacks than in schizophrenic whites, 3) immunoglobulin M in controls than in nonschizophrenic patients, and 4) immunoglobulin G (IgG) in schizophrenics whose urine was positive for phenothiazines than in schizophrenics whose urine was negative for phenothiazines. High serum levels of IgG were associated with no or mild hallucinations and low levels with moderate or severe hallucinations. Black female patients had significantly more severe hallucinaions than white female patients. The authors discuss the possible implications of these findings.     

Schizophrenic patients in the psychiatric interview: An experimental study of their effectiveness at manipulation.

This study attempted to examine whether chronic schizophrenic patients could effectively engage in the manipulative strategy of impression management in an evaluative interview situation. The data supported the expectation that schizophrenic mental patients can effectively present themselves as "sick" or "healthy," whichever is more suited to their needs and goals. Thus, when the patients' open ward status was questioned, they convincingly presented themselves in the interview as "healthy" and eligible for open ward living; when their residency status was questioned, they convincingly presented themselves as "sick" and ineligible for discharge. These findings were interpreted as supporting assumptions of patient effectiveness in implementing goals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Atopic eczema: a clinical psychiatric study

The method of Deutsch and Weeks was modified to provide a reliable and reasonably quick method for assaying the L-ascorbic acid content of culture medium. The modified method was used to determine the decay of L-ascorbic acid under various conditions of culture and the concentration of the vitamin in commercially prepared media. The half-life of L-ascorbic acid in a modified New circulator gassed with 95% O2 + 5% CO2 was 1.5 hr.; and when gassed with 20% O2 + 5% CO2 + 75% N2, about 2 hr. In Petri dishes gassed with 20% O2 + 5% CO2 + 75% N2, the half-life of L-ascorbic acid was 0.9 hr. About 4% of the L-ascorbic acid was lost per day when medium was stored at 0 degrees C and about 9% per day when stored at 5 degrees C. When medium with an initial content of 300 microng per ml was stored at room temperature, the half-life was found to be 15.5 hr. The L-ascorbic acid in five commercially available media, which contain the vitamin in their formulations, was assayed immediately after their delivery to the laboratory. The values of L-ascorbic acid measured in these media were in all cases far lower than prescribed. A continuous-flow organ culture system has been designed which allows the provision of a relatively constant level of L-ascorbic acid to explant by taking advantage of the slow oxidation of L-ascorbic acid at 0 degrees C.     

Infant death rates in Queensland, 1962 to 1972

Published statistical material has been used to analyse the infant death rate in Queensland. The neonatal death rates, which tend to reflect the level of obstetric care, were approximately twice as high in the Peninsula Division as in Brisbane, and the late infant mortality rate was almost eight times as high in the Peninsula Division as in Brisbane. In the Peninsula there has been no fall in infant death rate over the 11 years studied. One small area had an infant mortality rate of 100 deaths per 1,000 live births. The areas with the highest infant death rates were those with a significant Aboriginal population. The data show that proximity to major health facilities does not ensure low infant death rates and in the Brisbane Metropolitan Division there were threefold differences in late infant death rates. It seems likely that infant death rates are influenced by the economic status and education of parents and by the priority they place on infant care. The study has shown that published statistical data can detect areas within Queensland with high infant death rates, and could therfore be used to direct resources to improve the well-being of infants in these areas.     

Differences in late fetal death rates in association with determinants of small for gestational age fetuses: population based cohort study

OBJECTIVE: To examine differences in late fetal death rates in association with determinants of small for gestational age fetuses. DESIGN: Population based cohort study. SUBJECTS: 1 026 249 pregnancies without congenital malformations. SETTING: Sweden 1983-92. MAIN OUTCOME MEASURE: Late fetal death rate. RESULTS: Depending on underlying determinants late fetal death rates were greatly increased in extremely small for gestational age fetuses (range 16 to 45 per 1000) compared with non-small for gestational age fetuses (1.4 to 4.6). In extremely small for gestational age fetuses late fetal death rates were increased from 31 per 1000 in mothers aged less than 35 years to 45 per 1000 in older mothers, and from 22 per 1000 in women <155 cm in height to 33 per 1000 in women >=175 cm tall. Late fetal death rates were also higher in extremely small for gestational age fetuses in singleton compared with twin pregnancies and in non-hypertensive pregnancies compared with pregnancies complicated by severe pre-eclampsia or other hypertensive disorders. Slightly higher late fetal death rates were observed in nulliparous compared with parous women and in non-smokers compared with smokers. CONCLUSIONS: Although the risk of late fetal death is greatly increased in fetuses that are extremely small for gestational age the risk is strongly modified by underlying determinants-for example, there is a lower risk of late fetal death in a small for gestational age fetus if the mother is of short stature, has a twin pregnancy, or has hypertension.     

Mortality in insured Swedish dogs: rates and causes of death in various breeds

Data on over 222,000 Swedish dogs enrolled in life insurance in 1992 and 1993 were analysed. There were approximately 260 deaths per 10,000 dog-years at risk. Breed-specific mortality rates and causes of death are presented for breeds with more than 500 dogs at risk that had consistently high or low rates. Breed-specific mortality ranged from less than 1 per cent to more than 11 per cent. True rates and proportional statistics for the cause of death were calculated for the entire insured population (250 breeds) and cause-specific mortality rates were calculated for the breeds with the highest risk of dying of the most common causes. Trauma, tumours and problems related to the locomotor system together accounted for more than 40 per cent of all deaths or euthanasias. Although limited to insured dogs, these data cover approximately one-third of all Swedish dogs and provide baseline mortality data for further population-based studies on health and disease.     

Recruitment and retention of African American patients for clinical research: An exploration of response rates in an urban psychiatric hospital.

The issues related to recruiting African American psychiatric inpatients are discussed in the context of a study on the influence of ethnicity on psychiatric diagnosis. Ethnically diverse psychiatric residents interviewed 960 Black and White inpatients in 2 urban psychiatric hospitals. Despite the obstacles cited in the literature about recruiting and retaining African Americans into research, 78% of this sample were African American. In addition, interview completion and refusal rates did not differ by patient ethnicity. Results suggest that matching interviewer and patient ethnicity did not influence African Americans' likelihood of participating in or of refusing an interview. This article summarizes a number of guidelines that others may find useful in conducting clinical research with African Americans, ranging from the formation of academic-public liaisons to interviewer training. (PsycINFO Database Record (c) 2010 APA, all rights reserved)