Serum cholesterol changes from 1983-1984 to 1993-1994 in the People's Republic of China

BACKGROUND AND AIM: Increasing cardiovascular disease (CVD) mortality in the People's Republic of China (PRC) led to the 1981 establishment of the PRC-USA Study of Cardiovascular and Cardiopulmonary Epidemiology which, among other objectives, is concerned with the correlates of CVD morbidity and mortality in Chinese populations among other objectives. This report describes changes in total cholesterol (TC) levels in four PRC populations from 1983 to 1993 and identifies factors related to the changes. METHODS AND RESULTS: Population screenings carried out in 1983-1984, 1987-1988 and 1993-1994 involved the collection of demographic data, specimens (including blood), medical history and physical examination data. The data from cohort and independent samples were used to assess TC changes in urban and rural men and women over the decade, with and without adjustment for age and body mass index (BMI) changes. For Guangzhou men and women, the cohort analyses (aged 35-54 at baseline) showed increases in TC of 10-20 mg/dL after adjustment for age and changes in BMI; the independent sample analyses (aged 35-44) also showed higher average TC levels in 1993-1994 than in 1983-1984. For the Beijing cohorts, the results showed decreases in TC during the decade in men, an increase in TC in urban women and no change in rural women; the independent sample analyses indicated declines in TC for Beijing men and women. Possible reasons for the Guangzhou TC increases are economic growth, and dietary and BMI changes. The mean age-adjusted BMI significantly increased (5-10%) over the 10-year period in all of the studied groups. CONCLUSIONS: TC increased 10-20 mg/dL in Guangzhou men and women, probably as a result of socioeconomic development during the decade. The inconsistent patterns of TC changes in Beijing require further study.     

Age and occupational activity status of 45-59-year-old Danes from 1984 to 1994.

Analyses of the occupational activity of the 45-59-year-old Danes in the 10-year period 1984-1994 show that the decrease in occupational activity status is marked for women at the age of 50 and for men about 5 years later. Moreover, it is not possible to detect an increase in the occupational activity, as far as the employment rate is concerned, of the 45-59-year-olds during the same 10-year period.     

The training of united states rheumatologists, 1927-1976

A questionnaire completed in 1977 by 940 United States rheumatologists concerning the duration, content, and quality of their subspecialty training experience has been analyzed. The effect of quantitative changes in program content on the evaluation of such programs was elucidated by means of linear regression analysis. Respondents provided a rating scale for the content of future training programs. Stratification of responses by academic and nonacademic clinicians provides further insights into past and future training programs for rheumatologists in the United States.     

Changes in blood pressure and risk factors for cardiovascular disease among older Mexican-Americans from 1982-1984 to 1993-1994.

OBJECTIVE: To determine the 10-year changes in blood pressure and cardiovascular risk factors among older Mexican-Americans. DESIGN: Comparative analyses of the Hispanic Health and Nutrition Examination Survey (HHANES) and the Hispanic EPESE (Established Populations for Epidemiologic Studies of the Elderly). Both of these were population-based studies using a multistage stratified probability sampling design of noninstitutionalized persons. SETTING: Five US states in the southwest: Arizona, California, Colorado, New Mexico, and Texas. PARTICIPANTS: A total of 216 Mexican-Americans aged 65 to 74 from the 1982-1984 HHANES and 3050 Mexican-Americans aged 65+ from the 1993-1994 Hispanic EPESE. MEASUREMENTS: Mean systolic and diastolic blood pressure; cigarette smoking; high levels of alcohol use; body mass index and obesity; self-reported heart attack, stroke, and diabetes; hypertension. RESULTS: Among 65- to 74-year-old Mexican-Americans, there was a decrease over time in the percent of those who smoked cigarettes from 27.60% to 13.96% and a decrease in mean systolic blood pressure level. The percent of subjects categorized as obese or severely obese increased significantly, as did the prevalence of diagnosed diabetes, increasing from 20.06% in 1982-1984 to 29.82% in 1993-1994. Mean diastolic blood pressure increased from 77.15 mm Hg in 1982-1984 to 81.21 mm Hg in 1993-1994. CONCLUSIONS: Our findings suggest major changes in cardiovascular risk factors between 1982-1984 and 1993-1994 among older Mexican-Americans.     

BSG President's Report for 1994-5

p53 Protein accumulation in early gastric carcinoma was studied in relation to the histological type (Lauren classification) and the type of growth pattern, including the chronology of p53 protein accumulation during carcinogenesis. Forty five, paraffin embedded gastrectomy specimens from early carcinomas were examined for the presence of chronic atrophic gastritis, subtypes of intestinal metaplasia, and dysplasia. The Lauren type and the type of growth pattern were reassessed for all early carcinomas. p53 Protein accumulation was examined using the monoclonal antibody DO-7. Complete absence of p53 protein accumulation was observed in normal gastric mucosa, chronic atrophic gastritis, and intestinal metaplasia, irrespective of subtype. In gastric dysplasia (one mild, two moderate, and one severe), only severe dysplasia was p53 positive. Intestinal type (n = 20) and diffuse type early gastric carcinomas (n = 25) were p53 positive in 70% and 52% of cases, respectively. Both tumour types differed significantly in the percentage of p53 positive tumour cells per tumour (p < 0.01) and in staining intensity (p < 0.05). No significant difference in p53 protein accumulation was found between early carcinomas with different types of growth pattern. It is concluded that p53 protein accumulation--usually reflecting missense p53 gene mutation--seems to be a late event in gastric carcinogenesis. Moreover, it is suggested that missense p53 gene mutation occurs in a final pathway common to both intestinal and diffuse type of early gastric carcinoma. Finally, the types of growth pattern do not seem to differ in p53 protein accumulation.     

Trends in HIV and sexual behaviour in a longitudinal study in a rural population in Tanzania, 1994-2000

OBJECTIVE: To describe the trends in HIV transmission and sexual behaviour in a rural population in Africa. DESIGN: An open community cohort study with demographic surveillance and surveys of all consenting adults. METHODS: All residing adults aged 15-44 years who participated in surveys in 1994-1995, 1996-1997 and 1999-2000 were tested for HIV infection and provided information on sexual behaviour. The district AIDS control programme was the only intervention. RESULT: The prevalence of HIV among adults aged 15-44 years increased gradually from 5.9% in 1994-1995 to 6.6% in 1996-1997 and 8.1% in 1999-2000. The incidence of HIV increased from 0.8 to 1.3 per 100 person-years during 1994-1997 and 1997-2000, respectively. In spite of a modest increase in knowledge during the study period, most individuals continued to feel that they were not at risk of HIV, and sexual risk behaviour remained largely unchanged, except for a small increase in condom use. HIV transmission levels continued to be higher in the trading centre than in the nearby rural villages within this small geographical area, although differences became smaller over time. CONCLUSION: The gradual and continuing spread of HIV and the striking lack of change in sexual behaviour in this rural population suggest that the low-cost district intervention package does not appear to be adequate to stem the growth of the epidemic, and more intensive AIDS control efforts are needed.     

Survey of arthroscopy performed by rheumatologists

OBJECTIVE: To determine the international distribution and practice of arthroscopy performed by rheumatologists and to evaluate proposed guidelines on minimum standards for training in arthroscopy in the context of current clinical practice. METHODS: A questionnaire was sent to all rheumatology centres identified as practising arthroscopy, by (i) searching Medline from 1966 to 1999, (ii) searching the abstract books of the annual general meetings of ACR, BSR and EULAR from 1980 to 1999, and (iii) correspondence with all the centres identified. RESULTS: Thirty-six rheumatology centres were confirmed as performing arthroscopy (24 in Europe, 10 in USA and two in Australia) and 33 (92%) centres completed the questionnaire. Twenty-five (76%) of the 33 centres performing arthroscopy had started to perform it since 1990 and 72 rheumatologists are now trained in arthroscopy. A total of 16532 arthroscopies had been performed (median=220 arthroscopies/centre, range 20-5000); 50.5% of the arthroscopies had a primary clinical indication and 49.5% had a primary research indication. Most centres fulfilled the minimum standards for arthroscopic facilities and the proposed minimum standards in training were acceptable to 76% of respondents. Complication rates were calculated for 15682 arthroscopies where routine follow-up data were available [joint infection, 16 (0.1%); wound infection, 17 (0.1%); haemarthrosis, 141 (0.9%); deep venous thrombosis, 31 (0.2%); neurological damage, 3 (0.02%), thrombophlebitis, 12 (0.08%), other, 8 (0.06%)]. Irrigation volume correlated with wound infection rate (r=0.41, P=0.03) and centres performing cartilage biopsy had a higher rate of haemarthrosis (P=0.007). CONCLUSION: The last decade has seen rapid growth in arthroscopy performed by rheumatologists in an out-patient setting under local and regional anaesthesia. Proposed minimum standards for training in rheumatological arthroscopy reflect current practice accurately and are acceptable to the majority of arthroscopists. Complication rates of rheumatological arthroscopy are similar to those reported in the orthopaedic literature.     

Thyroid cancer in Iceland 1955-1984

A retrospective study was carried out on the incidence of thyroid cancer in Iceland from 1955 to 1984. During this 30-year period 406 cases of thyroid cancer were registered. The incidence of 9.5 for females and 3.4 for males per 100,000 per year is at least twice as high as in the other Nordic countries and among the highest incidence figures reported anywhere. A considerable increase in the reported incidence of thyroid cancer was noted around 1965. The mean size of the cancer nodules at diagnosis decreased at the same time and survival rates of patients improved. The incidence decreased again during the last 5 years of the study period. Mortality rates remained similar during this 30-year period. The survival rate corrected for intercurrent death was similar for both papillary and follicular carcinomas. All patients with anaplastic carcinomas died within one year of diagnosis. Cox's regression analysis with multiple covariates revealed that age at diagnosis, anaplastic and medullary history type as compared with papillary type, pathological evaluation of tumour extent, and calendar period of diagnosis had significant prognostic power. Sex and follicular vs papillary histology type were not significant prognostic factors.     

Incidence of mesothelioma in Glasgow 1981-1984

Considerable public concern exists about the effects of exposure to asbestos both at the workplace and in the general environment. In addition, the recording of mesothelioma in health registers is questionable both in terms of accuracy and completeness. This paper compares nine different sources of data for mesothelioma in an attempt to establish the true incidence of the disease in the geographical area of the Greater Glasgow Health Board between 1981 and 1984. Although 113 cases were identified, no single source identified more than 86 per cent of this total, thus presenting a case for a special mesothelioma register. A questionnaire-based study of the occupational exposures and residential histories of the cases was also carried out. It confirmed the findings of similar studies in that mesothelioma occurs predominantly in those exposed by reason of their occupation. No relationship with place of residence was apparent independent of occupation.