American journal of epidemiology
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Randomized Controlled Trial Clinical Trial
Divergent mortality for male and female recipients of low-titer and high-titer measles vaccines in rural Senegal.
The female/male mortality ratio among unimmunized children and children vaccinated with standard or high-titer measles vaccines was examined for all children born in the period 1985-1991 in a rural area of Senegal. The female/male mortality ratio from 9 months to 5 years of age for unvaccinated children was 0.94 (95% confidence interval (CI) 0.75-1.19), significantly different from the ratio of 0.64 (95% CI 0.48-0.85) for recipients of the Schwarz standard measles vaccine (p = 0.040). ⋯ Hence, the Schwarz standard and high-titer measles vaccines have divergent sex-specific effects on mortality throughout childhood. Further studies of the underlying mechanisms are needed.
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The relations between resting heart rate on electrocardiogram, usual physical activity, and risks of all noncardiovascular mortality, cancer mortality, and other noncardiovascular mortality were examined in 7,735 middle-aged British men drawn from general practices in 24 British towns. Subjects were examined and administered questionnaires in 1978-1980. During a follow-up period of 9.5 years (to December 1989), there were 334 deaths from noncardiovascular causes, including 225 cancer deaths. ⋯ The positive associations with cancer and all noncardiovascular mortality persisted even after further adjustment for lung function (forced expiratory volume in 1 second) and exclusion of men with underlying ill health and of deaths occurring within the first 5 years of follow-up. A significant inverse association with seen between physical activity and risk of cancer death, even after adjustment for the above factors and heart rate, with a significant reduction only in those engaged in high levels of usual physical activity (relative risk = 0.62, 95% CI 0.39-0.98). The data suggest that in middle-aged men, resting heart rate and physical activity are independent prognostic factors for cancer mortality.
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A population-based case-control study of the association between head trauma and Alzheimer's disease was conducted in the Netherlands from 1980 to 1987. The study comprised 198 patients with clinically diagnosed early onset Alzheimer's disease and 198 age- and sex-matched population controls. Adjusted for sex, age, family history of dementia, and education, the odds ratio of a history of head trauma with loss of consciousness was 1.6 (95% confidence interval (CI) 0.8-3.4). ⋯ However, the power to show interaction may have been low in this study. The authors' findings are compatible with the view that head trauma may be implicated in Alzheimer's disease, with a short lag time between the head trauma and the first symptoms of disease. The association needs to be confirmed in a prospective follow-up study to fully exclude the possibility of recall bias.
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The etiology of acute diarrhea (less than or equal to 3 days duration) and persistent diarrhea (greater than or equal to 14 days duration) was determined in Cambodian children under age 5 years in a refugee camp on the Thai-Cambodian border between May and October 1989; potential risk factors associated with persistent diarrhea were examined in an age-matched case-control study. Specimens collected from children and environmental sources were examined by standard microbiologic methods; Escherichia coli isolates were examined for hybridization with specific DNA probes and in tissue culture adherence assays. ⋯ The most important risk factors identified for developing persistent diarrhea were living with other young children (odds ratio (OR) = 2.0, 95% confidence interval (Cl) 1.2-3.4) and being undernourished (OR = 2.6, 95% Cl 1.2-5.7). Persistent diarrhea in children in this camp was associated with several different agents rather than persistent infections with a single organism.
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The authors examined the effects of smoking and alcohol use in a prospective community-based study of incident Alzheimer's disease. Two in-home interviews of the total elderly population of East Boston, Massachusetts, conducted in 1982 and 1985 were used to sample individuals for clinical evaluation for Alzheimer's disease. A total of 513 persons underwent detailed clinical evaluation including neurologic, neuropsychologic, and psychiatric evaluation to diagnose Alzheimer's disease. ⋯ For 40 pack-years of smoking, the odds ratio of Alzheimer's disease was 0.8 (95% confidence interval 0.6-1.1). Consumption of 1 oz (30 ml) of alcohol per day was associated with an odds ratio of 1.1 (95% confidence interval 0.8-1.5). These results suggest that recent mild-to-moderate consumption of alcohol is not substantially related to incidence of Alzheimer's disease and that smoking does not increase risk of the disease.