The New England journal of medicine
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There are major differences between the sexes in morbidity and mortality rates. At all ages males have higher death rates and are more frequently afflicted with the chronic diseases associated with considerable reductions in longevity. Trend data indicate that males have become relatively more disadvantaged during a period characterized by major advances in medicine and increased access to care. ⋯ There is some evidence that these differences are associated more with behavioral than with biologic factors. Certain shifts in age-specific mortality rates reflect sex-role-related changes in behavior--e.g., increased consumption of tobacco by women and a reversal in sex mortality ratio for cancer of the lung. Changes in sex roles may affect directly, or indirectly through family dynamics, the health status of both sexes.
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Two patients with colonic adenocarcinoma and Streptococcus bovis endocarditis suggested a possible association between the two. Non-enterococcal Group D streptococci were isolated from fecal cultures of 11 of 105 controls, 35 of 63 patients with carcinoma of the colon, seven of 25 with inflammatory bowel disease, four of 21 with non-colonic neoplasms and five of 37 with other gastrointestinal disorders. All such streptococci examined for lactose fermentation were S. bovis. ⋯ No other group had results significantly different from those of controls (P less than 0.05) although patients with inflammatory bowel disease were more frequently carriers. The carrier state was unrelated to age, hospitalization status, colonic stasis, gastrointestinal bleeding or recent barium-enema examination. The implications of this association are unknown.
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Because several lines of evidence suggest that HLA products might have an important function in the immune response to infectious agents, we studied the possible relation between immune response to vaccinia virus and HLA phenotype in 79 soldiers who received a primary vaccination. A low in vitro response to vaccinia virus was associated with HLA-Cw3 both in 49 subjects tested three to four weeks after vaccination (P less than 0.001) and in the remaining 30 subjects tested five to 11 weeks after vaccination (P = 0.035). Responses to unrelated antigens and phytohemagglutinin of lymphocytes tested before, three to four weeks and five to 11 weeks after vaccination indicated that this association was specific for vaccinia virus and suggested that differences in immune response to vaccinia were reflected in temporarily altered immune responsiveness to unrelated antigens. Our results indicate that HLA-Cw3 or an HLA product associated with Cw3 is involved in the cellular immune response to vaccinia virus.