American journal of epidemiology
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The relation of blood pressure, serum cholesterol, plasma fibrinogen, and coagulation factor VIIc with skinfold thickness at four sites (forearm, triceps, suprailiac, and subscapular) was examined in 2,948 white participants in the Northwick Park Heart Study. When considered separately, all four skinfolds were significantly associated with the four cardiovascular risk factors in males. Of the two limb skinfolds, forearm was consistently more strongly associated than triceps with the risk factors. ⋯ The associations with the four risk factors were consistently stronger for the two trunk skinfolds than the limb skinfolds. Triceps was somewhat more strongly associated with the risk factors than forearm skinfold except for plasma fibrinogen. Thus there are sex differences in the association of the distribution of subcutaneous fat with cardiovascular risk factors.
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The AIDS epidemic in New York City, 1981-1984. New York City Department of Health AIDS Surveillance.
Since the epidemic of the acquired immunodeficiency syndrome (AIDS) was first recognized in 1981, New York City has had more cases and a higher incidence than any other city in the world. As of July 31, 1985, 4,133 cases had been reported to the New York City Department of Health, a cumulative incidence of 59 cases per 100,000. The incidence of disease continues to increase with each year of the epidemic, with 28% more cases diagnosed and reported in the first six months of 1985 (874 cases) than in a similar period of 1984 (680 cases). ⋯ The percentage of cases represented by intravenous drug users in New York City is higher than in the United States as a whole, and 79% of all intravenous users with AIDS have had residence in New York City. Major changes observed over the period 1981-1984 include a decrease in the proportion of homosexual and bisexual men (63% to 56%); an increase in the proportion of intravenous drug users (13% to 29%); and the appearance of cases in three new groups at risk: children of parents in risk groups, transfusion recipients, and female sexual contacts of men in risk groups. The epidemic trends for the latter three groups appear to be similar to, but two years later than those seen for the epidemic in homosexual and bisexual men and intravenous drug users in New York City.
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The incidence rate for acute traumatic spinal cord injury in Olmsted County, Minnesota, for 1935-1981, standardizing for age, sex, and calendar year, was 54.8 per million person-years--83.4 for males and 27.7 for females. Thirty-eight per cent of cases died prior to hospitalization. The annual incidence rate for those reaching hospital alive was 34.2 per million person-years. ⋯ Considering all deaths within the first year after injury, the standardized mortality rate from spinal cord trauma was 25.5 per million person-years. Automobile-related injuries constituted half of all causes of spinal cord injury and death. An increase in both incidence and hospitalization rates of traumatic spinal cord injuries in the past 17 years was observed in young men, attributable to recreational and motorcycle-related events.
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The acquired immunodeficiency syndrome (AIDS) was first recognized among hemophiliacs in 1982. The authors have conducted investigations to determine the onset and incidence of AIDS among hemophiliacs and to determine trends in hemophilia mortality since the introduction of clotting-factor concentrates in the late 1960s. A survey of United States hemophilia treatment centers, supported by the Centers for Disease Control and the National Hemophilia Foundation, defined a population of hemophiliacs which was monitored for AIDS cases through June 1984. ⋯ AIDS cases also used more lyophilized clotting-factor concentrate, but only a small number of cases were reported with this information. 3) Improved care for hemophilia, including the use of clotting-factor concentrates, dramatically reduced hemophilia mortality rates during the 1970s. 4) In 1982, hemorrhage was the major cause of death among hemophiliacs. Deaths from non-alcoholic liver disease were also increased. AIDS incidence among hemophilia treatment center attendees was stable at 0.6 cases per 1,000 hemophilia treatment center attendees per year during 1982 and 1983 but increased sharply to 5.4 cases per 1,000 during the first quarter of 1984.
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The potential benefits of a high-risk and a population strategy to prevent cardiovascular disease deaths by lowering total serum cholesterol and diastolic blood pressure were estimated. The first strategy concentrates on the top 10% of the risk distribution, and the second strategy changes risk factor distributions of the entire population. With the high-risk strategy, lowering total serum cholesterol 20% and diastolic blood pressure to 90 mmHg would result in a 28% reduction in death from cardiovascular disease. ⋯ Changes in total serum cholesterol (20% lowering) and diastolic blood pressure (10% lowering) that have been achieved in nutrition intervention trials would result in a 50% decline in cardiovascular disease death rates if applied to the whole population. If population mean total serum cholesterol could be lowered to 190 mg/dl and population mean diastolic blood pressure could be lowered to 80 mmHg, a 70% reduction in cardiovascular disease death rates would be expected. This suggests that only a population approach can prevent the majority of deaths from cardiovascular disease in a community.