Risk of fatal and near-fatal asthma in relation to inhaled corticosteroid use.

Objective: To examine the relationship between patterns of use of inhaled beclomethasone dipropionate and the risk of fatal and near-fatal asthma.

Design: Nested case-control analysis of a historical cohort; a further analysis.

Setting: The 12,301 residents of Saskatchewan aged 5 to 54 years who were dispensed 10 or more asthma drugs from 1978 to 1987.

The effects of female sexual response in coitus on early reproductive processes.

Research has shown that infertility and its medical investigation are stressful for couples and have adverse effects on sexual functioning. The purpose of this study was to examine how female sexual functioning could influence aspects of the reproductive process. This question was examined within the context of the postcoital test (PCT) routinely performed during the infertility investigation.

Coronary artery disease mortality in patients treated for Hodgkin's disease.

The authors conducted a follow-up study of the association between mediastinal irradiation, chemotherapy, and mortality from coronary artery disease in 4665 patients treated for Hodgkin's disease. Study subjects were followed after the diagnosis of Hodgkin's disease until death or the closing date of the study. The average duration of follow-up was 7 years; 2415 patients died, and 124 cases of coronary artery disease were identified from death certificates, including 68 cases of acute myocardial infarction.

The use of beta-agonists and the risk of death and near death from asthma.

Background: Morbidity and mortality from asthma appear to be increasing, and it has been suggested that medications used to treat asthma are contributing to this trend. We investigated a possible association between death or near death from asthma and the regular use of beta 2-agonist bronchodilators.

Methods: Using linked health insurance data bases from Saskatchewan, Canada, we conducted a matched case-control study of subjects drawn from a cohort of 12,301 patients for whom asthma medications had been prescribed between 1978 and 1987.

Effect of hydrogenase and mixed sulfate-reducing bacterial populations on the corrosion of steel.

The importance of hydrogenase activity to corrosion of steel was assessed by using mixed populations of sulfate-reducing bacteria isolated from corroded and noncorroded oil pipelines. Biofilms which developed on the steel studs contained detectable numbers of sulfate-reducing bacteria (10 increasing to 10/0.5 cm).

Effect of combination endocrine therapy (LHRH agonist and flutamide) on normal prostate and prostatic adenocarcinoma. A histopathologic and immunohistochemical study.

The histopathology of 23 radical prostatectomies from patients with prostatic adenocarcinoma pretreated for 3-6 months with combination therapy including a luteinizing hormone-releasing hormone agonist and the antiandrogen drug flutamide was reviewed and compared with the pretreatment biopsies or transurethral resection material. After combination therapy, benign prostatic glands showed marked atrophy with prominent basal-cell layers, basal-cell hyperplasia, and epithelial-cell vacuolization. Immature squamous-cell metaplasia was present in seven cases.

Accuracy of telephone dietary recalls in elderly subjects.

Accuracy of telephone-administered dietary recalls was determined for 159 elderly subjects by comparing the telephone recalls of single midday meals consumed at congregate meal sites with data on actual intake for the meals. Accuracy was determined for kinds of food eaten, size of portions eaten, and content of 15 nutrients. Exact agreement between the two data sources on the kinds of food eaten occurred for only 55% of the observed food items.

Knowledge, attitudes, beliefs and practices related to AIDS among Montreal residents of Haitian origin.

We used interviews of 268 subjects to ascertain knowledge, attitudes, beliefs and practices related to AIDS among Montrealers of Haitian origin, from November 1987 through October 1988. The questions on knowledge included items on general knowledge about the disease (prevention of AIDS, treatment, nature and manifestations of the disease, screening and high-risk groups), and more specific questions about modes of HIV-1 transmission. The average correct answers to questions on general knowledge about AIDS was 81%.

Second cancers and other late side effects of cancer treatment. A review.

The author reviewed the question of late side effects of cancer treatment. A late side effect was defined as an unwanted and deleterious effect observed for the first time 12 months or longer after treatment. In a survey of articles published by The New England Journal of Medicine and The Lancet from 1968 to 1988, nine categories of late side effects were identified: second cancers, hormonal and reproductive effects, effects on the immunologic system, heart disease, effects on kidney and urinary bladder, effects on gastrointestinal organs, neurologic and psychological effects, pulmonary toxicity, and osteonecrosis.

Solid cancer risk after treatment of Hodgkin's disease.

We pooled the data from seven studies of second cancer risk after treatment of Hodgkin's disease (HD) and estimated the relative risks (RR) of solid cancers (SC) for the following two treatment groups: (1) radiotherapy, with or without chemotherapy; and (2) chemotherapy alone. For all treatment groups combined, the RR of SC was 2.1 (95% confidence limits: 1.

[Determination of the risk of a 2d cancer in patients treated for a first cancer].

A paradoxical effect of radiotherapy and chemotherapy for cancer is that some of these treatments can themselves cause new cancers. Most epidemiologic methods can be applied successfully to the investigation of this problem and this paper reviews various approaches that have already been used by various researchers. The authors first review the more traditional methods, i.

External comparisons with the case-cohort design.

The case-cohort design can be an economic alternative to the standard cohort design. Prentice (Biometrika 1986;73:1-11) showed how the case-cohort design can be used to obtain relative risk estimates for comparisons within the cohort being studied. In this paper, the authors consider ways in which the case-cohort design can be used for comparing risk in exposure groups within the cohort to the risk in an external population.

Toward an "unconfounded" classification of epidemiologic research design.

Existing classifications of research designs for epidemiologic studies are inconsistent and confusing because of the conceptual "confounding" of three distinct concepts: directionality in which exposure and outcome are investigated, sample selection criteria, and timing of the study proper with respect to the calendar times of exposure and outcome. The authors have attempted to construct a classification in which these three concepts comprise distinct (if not totally independent) axes. Closer attention to the distinctions described may help the planning and interpretation of epidemiologic studies, as well as facilitate future teaching and communication.

Leukemia after radiotherapy for first primary cancers of various anatomic sites.

The authors conducted a case-control study designed to evaluate the association between radiotherapy for a first primary cancer and subsequent leukemia risk. Study subjects were selected from four tumor registries (California, Connecticut, Kansas, and Massachusetts). Cases were subjects with two primary cancers; the second cancer was a leukemia diagnosed one year or more after the diagnosis of the first primary cancer.

Conditions for confounding of the risk ratio and of the odds ratio.

There are disagreements in the literature about the criteria to be used to ascertain whether or not a measure of association is confounded. The authors postulate the general principle that a crude unconfounded measure of association is structured as a weighted average of the stratum-specific values of the measure. They examine the relationships between stratum-specific measures of association, crude overall measures, and weighted averages of stratum-specific measures, and indicate how these relationships may be used to define criteria for the assessment of confounding in cohort studies in which the exposure, disease, and stratification variables are classified dichotomously.

Second primary cancers following treatment of Hodgkin's disease.

A cohort study designed to evaluate the carcinogenicity of treatment for Hodgkin's disease (HD) was conducted. This report describes 2,591 patients with HD diagnosed in 1940-75 and presents an analysis of follow-up findings through 1978. Seventy-four second primary cancers (excluding basal cell and squamous cell cancers of the skin and in situ carcinomas of the cervix uteri) were observed 1 year or more after diagnosis of HD, including 21 leukemias.

Analytic epidemiologic methods for research on nosocomial infections: definitions and examples.

Two types of epidemiologic studies are presented: the cohort study and the case-control study. The fundamentals distinction between the two methods is in the definition of the population groups for study. The cohort approach identifies groups with different exposure histories, whereas the case-control approach begins with groups with different health and disease characteristics.

[Long-term results of isolated anterior interventricular bypasses: analysis of the prognostic factors. Apropos of a series of 187 patients operated on between].

A total of 187 patients underwent isolated aorto-left anterior descending artery (LAD) bypass grafting with the internal saphenous vein (ISV) (= 65) and left internal mammary artery (IM) (n = 122). The respective indications of the two techniques were not systematized: the comparison of the main preoperative data of the two groups showed a statistically higher number of risk factors (p less than 0,01), more multivessel coronary lesions (p less than 0,02) and more patients with dyskinetic left ventricles (p less than 0,05) in the ISV bypass group. There were no statistical differences between the two groups in early postoperative mortality (IM: 0,8 p.