Lawrence Beeson

Cohort Studies of Fat Intake and the Risk of Breast Cancer — A Pooled Analysis

BACKGROUND Experiments in animals, international correlation comparisons, and case-control studies support an association between dietary fat intake and the incidence of breast cancer. Most cohort studies do not corroborate the association, but they have been criticized for involving small numbers of cases, homogeneous fat intake, and measurement errors in estimates of fat intake. METHODS We identified seven prospective studies in four countries that met specific criteria and analyzed the primary data in a standardized manner. Pooled estimates of the relation of fat intake to the risk of breast cancer were calculated, and data from study-specific validation studies were used to adjust the results for measurement error. RESULTS Information about 4980 cases from studies including 337,819 women was available. When women in the highest quintile of energy-adjusted total fat intake were compared with women in the lowest quintile, the multivariate pooled relative risk of breast cancer was 1.05 (95 percent confidence interval, 0.94 to 1.16). Relative risks for saturated, monounsaturated, and polyunsaturated fat and for cholesterol, considered individually, were also close to unity. There was little overall association between the percentage of energy intake from fat and the risk of breast cancer, even among women whose energy intake from fat was less than 20 percent. Correcting for error in the measurement of nutrient intake did not materially alter these findings. CONCLUSIONS We found no evidence of a positive association between total dietary fat intake and the risk of breast cancer. There was no reduction in risk even among women whose energy intake from fat was less than 20 percent of total energy intake. In the context of the Western lifestyle, lowering the total intake of fat in midlife is unlikely to reduce the risk of breast cancer substantially.

Comparison of Body Composition by Bioelectrical Impedance and Dual-Energy X-Ray Absorptiometry in Overweight/Obese Postmenopausal Women

The purpose of this study was to compare the Rudolph J. Liedtke (RJL) Sciences Quantum II system bioelectrical impedance analyzer (BIA) with the fan beam Hologic dual-energy X-ray absorptiometry (DXA, software V8.26a) for assessing body composition in postmenopausal obese women. Thirty-three postmenopausal overweight/obese females (mean age: 53.9+/-6.0 yr; mean weight: 91.3+/-17.5 kg; and mean body mass index [BMI]: 33.1+/-5.7 kg/m2) were evaluated for comparison of body weight (BW), fat mass (FM), percent FM (%FM), and fat free mass (FFM). The comparison was assessed by RJL Quantum 2 Cyprus 2.6 (Clinton Township, MI) BIA vs fan beam DXA Hologic QDR-4500A software V8.26a (ODR 4500 Hologic, Inc., Waltham, Mass). RJL-BIA and DXA measurements were performed at the same time. BW was measured using a balance scale (Detecto; Web City, MO) and these results were used for the RJL-BIA analysis. Balance weight was compared with DXA BW. Correlations between DXA and RJL-BIA for BW, FM, %FM, and FFM were 0.998, 0.980, 0.782, and 0.926 (p<0.01), respectively. Bland-Altman plots demonstrated general agreement between methods for BW, FM, %FM, and FFM. However, for the latter 3 metrics of body composition, one unit change using BIA does not correspond to one unit change using DXA, as there were systematic disagreements at either end of the range of values. But RJL-BIA could be a valid method for assessing body composition of overweight/obese postmenopausal women once appropriate validated regression equations have been developed.

En Balance Participants Decrease Dietary Fat and Cholesterol Intake as Part of a Culturally Sensitive Hispanic Diabetes Education Program

Purpose The purpose of this study was to assess dietary intake habits of Mexican American Hispanic adults participating in the En Balance diabetes education program. Methods En Balance is a 3-month culturally sensitive diabetes education intervention for Spanish-speaking Hispanics. Of the 46 participants enrolled, 39 mainly Mexican American Hispanic adults with type 2 diabetes completed the En Balance program. Participants lived in the Riverside and San Bernardino counties of California, and all participants completed the program by June 2008. Dietary intake was assessed at baseline and at 3 months using the validated Southwest Food Frequency Questionnaire. Results Clinically important decreases in glycemic control and serum lipid levels were observed at the end of the 3-month program. The baseline diet was characterized by a high intake of energy (2478 ± 1140 kcal), total fat (87 ± 44 g/day), saturated fat (28 ± 15 g/day), dietary cholesterol (338 ± 217 mg/day), and sodium (4236 ± 2055 mg/ day). At 3 months, the En Balance group mean intake of dietary fat (P = .045) and dietary cholesterol ( P = .033) decreased significantly. Low dietary intakes of docosahexaenoic acid, eicosapentaenoic acid, and vitamin E were also observed in these adults with type 2 diabetes. Conclusions The En Balance program improved glycemic control and lipid profiles in a group of Hispanic diabetic participants. En Balance also promoted decreases in dietary fat and dietary cholesterol intake.

Nutritional status of highland and lowland children in Ecuador.

UNLABELLED We assessed the nutritional status of children in Ecuador using anthropometric measurements and body composition. OBJECTIVES To determine whether living in the highlands in Quito was a predisposing factor to poor nutrition in children. METHOD We compared the children in highlands at 2772 m above sea level with their costal (605 m above sea level) counterparts at Santo Domingo de Los Colorados. By using the WHO standard reference 2007, we distinguished malnourished children from healthy children using Z-score of -2 as a cut-off point. RESULTS Mean Z-score indices for both height-for-age (HFA) and weight-for-age (WFA) were found to be significantly lower among urban children than for rural children (p < 0.001). Urban children were also four times more likely of becoming mildly stunted (OR = 3.95%, 95% confidence interval (CI): 1.818-8.448) and three times more likely of being mildly underweight (OR = 3.95%, 95% CI: 1.241-7.551). CONCLUSION Living in highland urban areas of Ecuador is a predisposing factor for poor nutrition among children.

Diesel exhaust exposure, its multi-system effects, and the effect of new technology diesel exhaust

Exposure to diesel exhaust (DE) from vehicles and industry is hazardous and affects proper function of organ systems. DE can interfere with normal physiology after acute and chronic exposure to particulate matter (PM). Exposure leads to potential systemic disease processes in the central nervous, visual, hematopoietic, respiratory, cardiovascular, and renal systems. In this review, we give an overview of the epidemiological evidence supporting the harmful effects of diesel exhaust, and the numerous animal studies conducted to investigate the specific pathophysiological mechanisms behind DE exposure. Additionally, this review includes a summary of studies that used biomarkers as an indication of biological plausibility, and also studies evaluating new technology diesel exhaust (NTDE) and its systemic effects. Lastly, this review includes new approaches to improving DE emissions, and emphasizes the importance of ongoing study in this field of environmental health.

Parents education and children nutritional status aged 2 to 5 in Zambia

HIV epidemic are still a global public health concern. In the HIV history is well documented through scientific literature, the effectivity of the antiretroviral therapies (ART). ART has dramatically improved the life expectancy of HIV. Even though, it’s necessary to monitor the causes of death of people with HIV/AIDS. The objective of this study was to estimate mortality risk in people diagnosed with HIV/AIDS in Puerto Rico (PR) from 2006 through 2011. We used a population-based study from the PR AIDS Surveillance System, a total of N=2,290 deaths were reported for the study period. The Cox Proportional Hazards Regression Method was used to identify determinants of mortality. The 71% were males. The 23.5% of deaths were related to HIV/AIDS. Age and Sex adjust death rates was 4.9 deaths per 1,000 population and a fatality rate was 22.2%. The Hazard Ratio [HR] for a HIV/AIDS cause of death in intravenous drug user [IDU] was HR=1.53; 95% confidence interval [IC], 1.37, 1.70 (p<0.001); in AIDS stage HR=7.53; 95% IC, 2.42, 23.4 (p<0.001); and with CD4 cell count ≥ 500 copies HR= 0.20; 95% IC, 0.16, 0.26 (<0.001). Deaths of people with HIV/AIDS in Puerto Rico were not related to the traditional HIV/AIDS causes of death. IDU population, males, AIDS stage of the disease and with low CD4 cell count has higher risk to die to HIV/AIDS cause of death. We recommended designing specific tertiary prevention strategies for IDU population.A cardiovascular disease (ACD) is the number one killer in adult population. South Asians have the highest rates of premature coronary artery diseases. At least 25% of coronary patients have sudden death or nonfatal myocardial infarction without prior symptoms. However, understanding coronary heart disease risk (CHDR) of people with subclinical ACD is critically important for initiating intensive primary prevention. We conducted a cross-sectional cluster survey of 752 subjects in a semi-urban population in India. Smoking status, total Cholesterol, HDL, LDL, TG, blood pressure and anthropometric was collected. 10-year CHDR of the population was estimated using Framingham criteria. Univariate and multivariate analysis was done to test the association between variables and CHDR. We found that 62.0%, 28.5% and 9.5% men; and 97.1%, 2.5% and 0.4% women respectively were at mild, moderate and severe CHDR. Of men <40 years 0.8%, 40-60 years 14.4%, and >60 years 27.3% were at high CHDR; and among women, only the postmenopausal group were high CHDR. TG, LDL and systolic BP correlated directly; and height and biceps skinfold inversely with the CHDR in men. Systolic BP and TG correlated directly and height inversely with the CHDR in women. To conclude, men of all the age groups and women >60 years were at high risk for CHD over next 10-years. WHR was the best anthropometric predictor for CHD risk in both genders. Smoking and low HDL levels attributed significantly to the CHD risk in men compared to women. Further studies are warranted for implementing CHDR reduction intervention program in the population.Chronic kidney disease (CKD) is increasing globally and in Saudi Arabia it affects approximately 8% annual increment of dialysis population. It is associated with a high symptom burden. Previous studies have largely reported on the prevalence of symptoms only in the haemodialysis population. This study examined symptom burden across disease stages and treatment groups in advanced CKD, and their correlation with demographic and clinical factors. Using a cross-sectional design, a convenience sample of 436 patients with CKD was recruited from three hospitals in Saudi Arabia. The CKD Symptom Burden Index (CKD-SBI) was used to measure 32 CKD symptoms. Demographic and clinical data were also collected. Of the sample 75.5% were receiving dialysis (haemodialysis, n = 287; peritoneal dialysis, n = 42) and 24.5% were non-dialysis (CKD stage 4, n = 69; CKD stage 5, n = 38). Average symptom reported was 13.01 ± 7.67. Fatigue and pain were common and burdensome across all symptom dimensions.Approximately one-third of participants experienced sexual symptoms. Dialysis patients reported greater symptom burden, especially patients on haemodialysis. Haemodialysis treatment, older age and being female were independently associated with greater total symptom burden. In conclusion, symptom burden is high among advanced stages of CKD, particularly among those receiving dialysis. Although fatigue, pain and sexual dysfunction are key contributors to symptom burden in CKD, these symptoms are often under-recognised and warrant routine assessment. The CKD-SBI offers a valuable tool to assess symptom burden, leading to the commencement of timely and appropriate interventions.Background: The literature demonstrated that stethoscope, the most used medical device, can be more contaminated than hands. There is a big concern on disinfecting the health professional hands, contrarily, lack of time and attention make the stethoscope disinfection quite rare, although it should be disinfected before every visit. This pilot study, evaluates an innovative solution for stethoscopes’ membrane disinfection in a real environment.H infections with Toxocaracanis and cati are clinically important subjects and a frequent cause of misdiagnosis or delayed diagnosis. Despite the recognition of toxocariasis as an important clinical illness there have been few reviews of therapy for these infections and no definitive treatment protocols have been published, especially in albendazole and mebendazole resistant cases. Only a handful of agents have been used in therapy, and the agents which are available may vary in significantly in efficacy and have adverse effects or be contraindicated in certain clinical situations. When evaluating the clinical efficacy of agents used against toxocara infections, it is difficult to compare studies. They vary as to entry methodology (whether randomization was done and if treatment was blinded or open), population studied (children, adults), syndromes treated: visceral larva migrans (VLM), covert toxocariasismilder version of VLM and ocular larva migrans (OLM), measures (clinical efficacy and/or blood results negativity), and duration of follow-up. Nevertheless, conclusions may be drawn from the studies when viewed as a whole, and statements can be made about the relative efficacy of the agents. In this paper we present our own experiences and initial results about the efficacy of agents currently used for the treatment of toxocariasis in albendazole and mebendazole resistant cases. The total of 58 patients primarily treated with albendazole and/ or mebendazole were treated with two of the medicines most commonly used for resistant cases of this infection. 26 with visceral larva migrans, 26 with covert toxocariasis and 6 with ocular larva migrans. Diethycarbamazine and thiabendazole were used in their usual posologic schedules. The total cure rates achieved with diethylcarbamazine and thiabendazole were, respectively: 75% and 70% in VLM patients, 85% and 80% in covert toxocariasis. We did not achieve any clinical efficacy or blood results negativity in patients with OLM. Side effects were of minor importance both in patients treated with thiabendazole and diethylcarbamazine.H avian influenza viruses (AIVs) have become endemic and circulated in poultry industries in Korea since the first outbreak in 1996. We surveyed H9N2 AIVs in Korean chicken farms and live bird markets from 2009 to 2014. A total of 156 H9N2 AIVs was isolated, and we compared the genetic characteristics of theAIV isolates withH5N1 and H5N8 highly pathogenic influenza viruses (HPAIVs) isolated in Korea. Phylogenetic analysis classified the H9N2 AIVs into three categories of genotypes and showed that genetic reassortment had occurred among H9N2 AIVs, HPAIVs and AIVs isolated from wild birds. The first group of H9N2 AIVs were closely related to A/chicken/Korea/01310/2001 H9N2 (01310) which has been used for an H9N2 vaccine strain in Korea. The other two groups showed there assortment of polymerase genes each other between H9N2 AVI and HPAIV. The PB1 genes were similar to H5N8 HPAIV isolated in 2014, and the PB2 genes were closely related to H5N1 HPAIs. The PA genes of the second group were from 01310-like lineage, but those of the third group from HPAIVlike lineage. Considering that many kinds of the similar genetic reassortants of H9N2 AIVs have been reported in the several East Asian countries and H9N2 AIVs are thought as one of the potential pandemic candidates, continuous surveillance and monitorings should be conducted and investigated for the control of further epidemics.