Tension-reducing effects of alcohol: Further evidence and some methodological considerations.

Studied the relations among alcohol consumption, self-reported distress, and muscular tension in 4 male 28-45 yr old male chronic alcoholics. Ss were permitted free access to beverage alcohol and were monitored for blood alcohol level, electromyographic response, and subjective distress every other hour of their waking day for 12 days. Pearson product-moment correlations revealed (a) significant negative correlations between blood alcohol level and electromyographic response, (b) a significant positive correlation between blood alcohol level and subjective distress, and (c) no relation between electromyographic response and subjective distress. Results, while supporting a tension-reduction model of the effects of alcohol, reveal a complex interaction between alcohol consumption, subjective distress, and muscular tension. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevalence of cardiovascular risk factors in a French population

STUDY ON THE IDENTIFICATION OF CARDIOVASCULAR RISK FACTORS: Identification of cardiovascular risk factors and the estimation of their prevalence in different populations is an important aim of preventive medicine. We analysed the data from 58,803 volunteers who were subjected to systematic health examinations in the Centre d'Investigations Préventives et Cliniques in Paris during the period January 1991 to December 1993. In this report we present some results concerning the prevalence of the major cardiovascular risk factors and their associations with sex, age and the presence of hypertension. CONCLUSIONS: The present study clearly shows that before the age of 55 years, the prevalence of risk factors is higher in men than in women, whereas in postmenopausal women the risk-profile increases rapidly, reaching the level of men after the age of 65 years. The presence of multiple risk factors is much higher in hypertensive than in normotensive individuals. We also observed that more than two-thirds of the treated hypertensives had systolic/diastolic blood pressure levels of > 140/90 mmHg. These observations could contribute to the debate regarding the evaluation of global risk and therapeutic strategies in cardiovascular disease prevention.     

Low fat intake and coronary artery disease in a population with higher prevalence of coronary artery disease: the Indian paradox

OBJECTIVE: To determine the association between saturated fat intake and prevalence of coronary artery disease (CAD) and coronary risk factors. DESIGN AND SETTING: Total community cross sectional survey of 20 urban streets out of 196 streets, in the city of Moradabad in north India. SUBJECTS AND METHODS: Adult population between 25 to 64 years inclusive comprised of 1806 subjects (904 men, 902 women) were divided into three groups according to level of saturated fat intake as assessed by 7-day dietary intake records (very low < 7%, low 7 to 10%, high > 10% energy (en) per day). RESULTS: We examined the relationship between CAD risk and levels of % en from fat intake. Low (7 to 10% en/day) and high (> 10% en/day) saturated fat were positively and significantly associated with higher prevalence of CAD. The prevalence of coronary risk factors (hypertension, hypercholesterolemia, obesity and sedentary lifestyle) were significantly higher among subjects with low and high saturated fat intake compared to subjects with very low (< 7%) saturated fat intake. Logistic regression analysis with adjustment for age showed that hypercholesterolemia (OR: men 0.89, women 0.68), hypertension (men 0.92, women 0.56), physical activity (men 0.80, women 0.36), obesity (men 0.82, women 0.88) and smoking (0.70 men) were significant risk factors of CAD. Low and high saturated fat intake were associated with more prestigious occupations, higher and middle income status and better educational levels compared to very low saturated fat intake. CONCLUSIONS: The prevalence of CAD and coronary risk factors was higher in urban Indians with low and high saturated fat intake than those with lower saturated fat intake. These findings suggest that the saturated fat intake should be < 7% en/day for prevention of CAD in Indians.     

Acamprosate and alcohol: I. Effects on alcohol intake following alcohol deprivation in the rat

Acamprosate (calcium-acetyl homotaurinate) is a new compound in the treatment of alcoholism. Its efficacy has been proven in several clinical trials and registration is now pending in most European countries. The basic mechanisms by which acamprosate elicits its anti-craving action, thereby leading to reduced relapse rates, is not known at the moment. In the present study we describe a rat model of long-term alcohol-drinking which mimics relapse behavior in human alcoholics. The effect of acamprosate was studied in this model. Wistar rats had a free choice between water and alcohol solutions of different concentrations (5, 10, 20% v/v). After two months of continuous alcohol access, rats were deprived of alcohol for three days. Following this deprivation phase, all alcohol solutions were presented again. This procedure was repeated monthly for the following six months. The rats consumed 3.5 +/- 0.3 g/kg alcohol a day. After alcohol deprivation, alcohol intake rose to 5.2 +/- 0.3 g/kg per day resulting in blood alcohol levels of 30 +/- 6 mg/dl. Interestingly, the addition of quinine to the alcohol solutions or the additional presentation of a 5% sucrose solution did not affect the alcohol-deprivation effect after eight months of this intermittent alcohol exposure. However, when acamprosate (50-200 mg/kg i.p.) was administered twice daily, alcohol-drinking following an alcohol-deprivation phase was decreased dose dependently. Given at the highest dose alcohol intake even dropped significantly below baseline drinking. Together, these results show that acamprosate effectively diminishes the alcohol-deprivation effect. Furthermore, the described model seems to be a suitable animal model to screen compounds for their anti-relapse properties and subsequently for their anti-craving action.     

Epidemiology and risk factors of wedge-shaped defects in a Swiss population

The purpose of this study was to determine the prevalence of wedge-shaped abrasion defects in the teeth of an adult Swiss population. 980 letters explaining the study were sent to randomly selected subjects. 391 persons (40%) belonging to two age groups (26-30 and 46-50 years) were checked for frequency and severity of wedge-shaped lesions on all buccal tooth surfaces. Furthermore patients were asked about dietary and prophylactic habits as well as other factors possibly relevant to this study. The frequency of severe wedge-shaped defects was 19.1% in the younger, and 47.2% in the older age group, with a mean of 3 affected teeth per person (pooled age group). On average, 34.8% of all patients suffered from tooth hypersensitivity. 84.6% of the examinees with wedge-shaped defects complained of hypersensitivity at these sites. It is concluded that wedge-shaped defects cause considerable problems to more than one third of the population, and that such lesions are often combined with hypersensitivity of affected teeth.     

Dietary risk factors for colon cancer in a low-risk population

Spontaneous EEG was registered under different activity conditions in 26 volunteers. The EEG synchronisation parameters were compared with the geomagnetic and solar activity on the day of experiment. A positive correlation of the EEG data with the geomagnetic activity was revealed, being most obvious in the frontal and central areas. A negative correlation between some local EEG synchronisation parameters and different indices of the solar activity, was also revealed. The degree of synchronisation of the spontaneous EEG seems to reflect sensitivity of the human nervous system to the Earth's magnetic field. A stressor response to strong short-term disturbances in the geomagnetic field reveals itself in the form of enhancement of the EEG global synchronisation. A sedative effect of slow magnetic oscillations is locally revealed in the parameters of the EEG synchronisation within the left hemisphere as well as the interhemisphere synchronisation.     

Genetic and environmental risk factors for Parkinson's disease in a Chinese population

An epidemiological study of the environmental and genetic factors as well as the possible interplay between them was conducted among 215 patients with Parkinson's disease and 313 controls in a Chinese population in Hong Kong. In univariate analysis, a regular tea drinking habit was found to be a protective factor, which had not been reported before. Smoking (a protective factor), family history, duration of pesticide exposure (in years) in farming and pesticide exposure during farming in women (both risk factors) have been reported previously. In multivariate analysis, current smoking reached borderline significance at the 5% level and the variables, years exposed to pesticides and family history were significant at the 10% level. By contrast with the common occurrence of polymorphism of the CYP2D6 gene (a gene involved with xenobiotic metabolism) in white people, it is very rare in China and is not thought to be a significant factor contributing to Parkinson's disease in Chinese people.     

Prevalence of high blood pressure and associated coronary risk factors in an adult population of Mexico City

The application of managed care to dialysis raises concerns that dialysis will be rationed in the United States. Rationing means the implicit or explicit denial of beneficial or marginally beneficial medical treatment as a result of insufficient resources to provide treatment to all. In this era of cost containment and budget cutting, rationing appears inevitable in the end-stage renal disease program because of its continued growth in numbers and cost and because many are questioning the benefit of dialysis to certain groups of patients. Rationing according to social worth, ability to pay, or age is not ethically justifiable, but it is justified to ration according to medical benefit. There is an important role for guidelines developed with broad input from patients, families, health care professionals, ethicists, health policy experts, and payers. Consensus statements exist in the literature, and the nephrology community is in the process of developing practice guidelines that will be available for future use. In the meantime, managed care companies should look to broader community input in the form of consensus statements and community dialogue. Managed care companies will need ethics committees to ensure that their policies and procedures for rationing are fair, principled, and subject to review and appeal.     

Flavonoid intake and coronary mortality in Finland: a cohort study

OBJECTIVE: To study the association between dietary intake of flavonoids and subsequent coronary mortality. DESIGN: A cohort study based on data collected at the Finnish mobile clinic health examination survey from 1967-72 and followed up until 1992. SETTINGS: 30 communities from different parts of Finland. SUBJECTS: 5133 Finnish men and women aged 30-69 years and free from heart disease at baseline. MAIN OUTCOME MEASURE: Dietary intake of flavonoids, total mortality, and coronary mortality. RESULTS: In women a significant inverse gradient was observed between dietary intake of flavonoids and total and coronary mortality. The relative risks between highest and lowest quarters of flavonoid intake adjusted for age, smoking, serum cholesterol concentration, blood pressure, and body mass index were 0.69 (95% confidence interval 0.53 to 0.90) and 0.54 (0.33 to 0.87) for total and coronary mortality, respectively. The corresponding values for men were 0.76 (0.63 to 0.93) and 0.78 (0.56 to 1.08), respectively. Adjustment for intake of antioxidant vitamins and fatty acids weakened the associations for women; the relative risks for coronary heart disease were 0.73 (0.41 to 1.32) and 0.67 (0.44 to 1.00) in women and men, respectively. Intakes of onions and apples, the main dietary sources of flavonoids, presented similar associations. The relative risks for coronary mortality between highest and lowest quarters of apple intake were 0.57 (0.36 to 0.91) and 0.81 (0.61 to 1.09) for women and men, respectively. The corresponding values for onions were 0.50 (0.30 to 0.82) and 0.74 (0.53 to 1.02), respectively. CONCLUSIONS: The results suggest that people with very low intakes of flavonoids have higher risks of coronary disease.     

Macronutrient intake and cardiovascular risk factors in older coloured South Africans

A cross-sectional analytical study was undertaken to investigate the macronutrient intake and cardiovascular risk factor profile of community-dwelling older coloured (mixed descent) South Africans. A sample of 200 subjects aged 65 years and above in Cape Town was randomly drawn using a two-stage cluster design. Trained field workers interviewed subjects to obtain demographic, dietary and life-style data, to draw fasting blood samples for the analysis of plasma lipids, and to take anthropometric measurements. Nutrient intake was assessed using a validated quantified food frequency questionnaire. Blood pressure was measured according to the guidelines of the American Heart Association. The mean daily energy intake was 7984 (3245) kJ and 6979 (2219) kJ for men and women, respectively. Twenty-nine per cent of the subjects had energy intakes less than two-thirds of the RDA. Dietary fat intake comprised 32.4% of total energy intake, which is in line with the prudent dietary guidelines. The inadequate fibre intake (mean = 17(8) g/day) was attributed to the low consumption of fruit and vegetables. Anthropometric assessment indicated that the women tended towards overnutrition, while the men appeared to be undernourished. Lipid profiles fell within the lower end of the moderate risk band for cardiovascular disease and a high prevalence of hypertension (71.7%) was identified. The survey findings indicate a need for health promotion activities to encourage increased physical activity levels and an increased consumption of vegetables, fruit, wholegrain cereals and low fat dairy products in this population.     

Dietary fat intake and the risk of coronary heart disease in women

BACKGROUND: The relation between dietary intake of specific types of fat, particularly trans unsaturated fat and the risk of coronary disease remains unclear. We therefore studied this relation in women enrolled in the Nurses' Health Study. METHODS: We prospectively studied 80,082 women who were 34 to 59 years of age and had no known coronary disease, stroke, cancer, hypercholesterolemia, or diabetes in 1980. Information on diet was obtained at base line and updated during follow-up by means of validated questionnaires. During 14 years of follow-up, we documented 939 cases of nonfatal myocardial infarction or death from coronary heart disease. Mutivariate analyses included age, smoking status, total energy intake, dietary cholesterol intake, percentages of energy obtained from protein and specific types of fat, and other risk factors. RESULTS: Each increase of 5 percent of energy intake from saturated fat, as compared with equivalent energy intake from carbohydrates, was associated with a 17 percent increase in the risk of coronary disease (relative risk, 1.17; 95 percent confidence interval, 0.97 to 1.41; P=0.10). As compared with equivalent energy from carbohydrates, the relative risk for a 2 percent increment in energy intake from trans unsaturated fat was 1.93 (95 percent confidence interval, 1.43 to 2.61; P<0.001); that for a 5 percent increment in energy from monounsaturated fat was 0.81 (95 percent confidence interval, 0.65 to 1.00; P=0.05); and that for a 5 percent increment in energy from polyunsaturated fat was 0.62 (95 percent confidence interval, 0.46 to 0.85; P= 0.003). Total fat intake was not signficantly related to the risk of coronary disease (for a 5 percent increase in energy from fat, the relative risk was 1.02; 95 percent confidence interval, 0.97 to 1.07; P=0.55). We estimated that the replacement of 5 percent of energy from saturated fat with energy from unsaturated fats would reduce risk by 42 percent (95 percent confidence interval, 23 to 56; P<0.001) and that the replacement of 2 percent of energy from trans fat with energy from unhydrogenated, unsaturated fats would reduce risk by 53 percent (95 percent confidence interval, 34 to 67; P<.001). CONCLUSIONS: Our findings suggest that replacing saturated and trans unsaturated fats with unhydrogenated monounsaturated and polyunsaturated fats is more effective in preventing coronary heart disease in women than reducing overall fat intake.     

Low birth weight: some considerations in a Zambian population

A retrospective analysis of 2401 consecutive births revealed a lowbirth weight rate of 11.4 percent of all births and 14.2 percent all live borns. Sixty-five percent of late fetal and first week neonatal deaths were low birthweight babies. The cause of low birthweight labour was unknown in 48.2 percent of cases. The major known associations with low birthweight labour and delivery were twin birth, antepartum haemorrhage, premature rupture of the membranes and toxaemia of pregnancy. Nutritional factors were considered to be of significance in the incidence of low birthweight. The earlier attendance of mothers at ante-natal clinics and the availability of experienced medical and nursing personnel with adequate facilities are necessary for perinatal mortality to be significantly reduced in the low birthweight group.     

Open-heart surgery in a growing geriatric population: patient selection and risk factors to be considered

AIMS: This report describes our experience with cardiac surgery in elderly patients and aims to ascertain predictors of poor outcome. PATIENTS: Five hundred and ninety-eight (598) consecutive patients aged 75 years and older underwent cardiac surgery at the Department of Cardiothoracic Surgery, University Hospital of Lund, Sweden, between January 1980 and December 1993. There were 324 men (54%) and 274 women (46%); their age varied between 75 and 91 years (mean age +/- SD, 77.8 +/- 2.6 years). One hundred and twenty-nine patients underwent aortic, mitral or combined valve replacement, 273 patients underwent exclusive coronary revascularization (CABG) alone and 109 underwent a surgical procedure which included valve replacement and concomitant CABG. The remainder (87 patients) underwent other, more complex surgical procedures. RESULTS: The 30-day or in-hospital mortality rate was 5.5% (0.8% for valve replacement, 5.1% for CABG, 5.5% for valve replacement with concomitant CABG, and 12.6% for other procedures). Concomitant severe diseases occurred in 34.9% of the patients. All surviving patients were evaluated during June 1994. None of the patients was lost to follow-up. The 566 long-term survivors have been followed for an average of 23.0 months (median 21; range 1-53 months). Late mortality was 12.0% in the 566 hospital survivors. Only 17 patients experienced late complications (after hospital discharge), as an adverse effect linked to heart surgery.     

The relationship between blood pressure and biochemical risk factors in a general population

The relationship between blood pressure, ponderal index, sex, blood glucose, haemoglobin, serum uric acid, calcium cholesterol and creatinine, and albumin has been examined in 698 subjects aged between 44 and 49 years from the register of a group general practice. Sixty per cent of the variation in systolic pressure could be explained by statistically significant associations with diastolic pressure, sex, blood glucose, serum calcium, and cholesterol. The diastolic blood pressure (not corrected for systolic pressure) was significantly related only to ponderal index, haemoglobin in men, and cholesterol in women. Pulse pressure was also positively related to the risk factors blood glucose, serum cholesterol, and calcium. The possibility is discussed that one or more of these variables reduce aortic compliance and that the serum calcium contributes to this end. Diastolic, but not systolic pressure, had a prime association with relative weight, obesity being only basically associated with an increase in diastolic pressure.     

Profile of some risk factors for coronary heart disease in a developing country: Nigeria

We examined visual evoked potentials and pattern electroretinograms in a patient with Tolosa-Hunt syndrome associated with optic nerve involvement. The 82-year-old woman developed unilateral painful ophthalmoplegia and visual loss in the right eye. Magnetic resonance imaging showed an abnormal soft-tissue area in the right cavernous sinus and the right orbital apex. Symptoms responded rapidly to treatment with corticosteroid. Visual evoked potentials to flash and pattern stimuli were both remarkably reduced and delayed in the right eye in the acute stage; however they improved to almost normal after steroid therapy. The pattern electroretinogram recorded in the acute stage was normal bilaterally. These results indicate that optic nerve involvement in Tolosa-Hunt syndrome can be mild and reversible.     

Role of psychosocial factors in obtaining self-reports of alcohol use in a DUI population.

Psychosocial and situational factors were examined as predictors of discrepant reports between 128 DUI offenders (respondents) and 82 of their collaterals (e.g., relatives and friends). Psychosocial factors included respondents' expectancies about telling the truth, normative beliefs, attitudes, confidentiality, perceived tension, and certainty about their accuracy. Ss' reports were assessed in 1 of 3 settings: self-administered at DUI school, group administered at DUI school, or self-administered at home. Overall, respondents reported greater alcohol intake than did collaterals. Respondents also reported greater levels of drinking when they were more certain of their accuracy and when they were concerned that confidentiality might be violated. Discrepancies were primarily attributable to psychosocial and not to situational factors. Decreased collateral familiarity with the respondent's drinking was also related to greater discrepancies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating biological and behavioral factors in alcohol use risk: The role of ALDH2 status and alcohol expectancies in a sample of Asian Americans.

Prior studies have shown that the ALDH2*2 genetic variant, most common in individuals of Asian descent, is related to heightened sensitivity to alcohol and can serve as a protective factor against alcohol problems. This study explored the effect of this factor on alcohol expectancies. It was hypothesized that (a) individuals with ALDH2*2 alleles would have lower positive expectancies and higher negative expectancies, (b) expectancies would mediate the ALDH2-drinking relation, and (c) ALDH2 status would moderate the expectancy-drinking relation. Data were collected from 171 Asian American university students. Positive expectancy and ALDH2 status were correlated with alcohol use. Mediation and moderation hypotheses were supported only in the female sample. Results were not significant for negative expectancies. These results indicate that ALDH2 status may protect against drinking by lowering positive expectancies and reducing the expectancy-drinking relationship. (PsycINFO Database Record (c) 2010 APA, all rights reserved)