Geographic variation in prostate cancer mortality rates among white males in the united states

PURPOSE: The most recent atlas of cancer mortality in the United States revealed elevated prostate cancer mortality rates among white males in the northwest, Rocky Mountain, northcentral, and southeast areas, as well as New England, especially during the 1970-94 period. We wanted to test whether this observed geographic variation was simply due to chance or not.METHODS: We used a spatial scan statistic using mortality data for 506 state economic areas.RESULTS: There were four significant clusters with elevated risks of prostate cancer mortality (P < 0.001). The most prominent cluster was in the northwestern quadrant of the country, followed by clusters in New England, the midwest, and southeast regions. Within the northwestern cluster, we also detected seven significant sub-clusters (P < 0.05).CONCLUSIONS: We concluded that the observed geographic variation of prostate cancer mortality is indeed real, and deserves further study into the underlying determinants.     

Esophageal and gastric candidiasis

The authors examined the morbidity rate of mycotic diseases of stomach and esophagus. There were 746 biopsian and abrasian cytologic samplings carried out in a year and 12.3% of the cases turned out to be positive. Comparing the two sampling patterns the abrasian cytology has proved to be more effective. The prevalence of candidiasis was found to be higher in case of malignant diseases. In states accompanied by low acid values (as in case of patients under H2-receptor blocking--treatment) mycotic infection proved to be more frequent, too.     

中国2006—2007年诺如病毒胃肠炎暴发及其病原学特征分析

目的了解上海市聚集性呕吐腹泻疫情的流行病学特征。方法收集汇总2017年1—12月上海市发现和报告的聚集性呕吐腹泻疫情的调查报告,统计分析所有疫情的三间分布特征、病例临床特征、主要感染原因和病原菌等。结果本市聚集性呕吐腹泻疫情发病高峰在冬春季,有79.23%的疫情发生在11月到次年3月;以郊区为主,浦东新区和松江区报告了全市30%的疫情,而中心城区如徐汇、静安、黄浦3区仅报告了10%的疫情;96.92%的疫情发生在学校和幼儿园;病例临床表现以呕吐、腹泻为主,其中有呕吐症状的占91.26%;人传人接触传播是本市疫情的主要传播形式,占93.85%;诺如病毒是本市疫情的首要病原,占74.62%;疫情持续时间与首发病例出现到首次调查处置的时间间隔存在正相关。结论2017年上海市聚集性呕吐腹泻疫情主要发生在冬春季和集体单位,诺如病毒是其主要病原体,应加强重点地区和人员的监测及防护工作。     

Obesity in infants,children, and adolescents in the united states II. causality

Investigations of the causality of obesity are broadly divided into host and environmental categories. Among host characteristics, age, sex and race appear to have no consistent effect on the prevalence of obesity among children in the United States. Reduced thermogenesis may enhance susceptibility to obesity, but the onset of the disease reflects energy intakes in excess of expenditure. Clinical conditions causing impaired regulation of energy balance are rare. The multiple environmental variables associated with obesity, primarily those within families, suggest that the factors that promote excessive energy intake for expenditure are behavioral. Although definitive proof of a causal relationship is lacking, these data suggest that the origins of obesity are environmental.     

Esophageal cancer and microelements

Epidemiological studies have identified dietary zinc deficiency, methylbenzylnitrosamine, and ethanol as factors strongly associated with an increased incidence of esophageal carcinoma in man. In addition, these studies have identified other trace elements which may also affect the incidence of esophageal carcinoma. Animal models have confirmed that dietary zinc deficiency increases the incidence of methylbenzylnitrosamine-induced esophageal carcinoma and that dietary zinc deficiency also increases the incidence of other dialkylnitrosamine-induced carcinomas. The dialkylnitrosamine carcinogens are activated by NADPH-dependent cytochrome P-450 enzymes in their target tissues. The activated methylbenzylnitrosamine methylates DNA, forming O6-methylguanine adducts. These O6-methylguanine adducts can lead to point mutations in DNA, and such mutations are known to be responsible for the induction of certain carcinogen-induced tumors. We have demonstrated that dietary zinc deficiency increased the cytochrome P-450-dependent microsomal metabolism of methylbenzylnitrosamine and dimethylnitrosamine, two members of this class of dialkylnitrosamine carcinogens, while the addition of zinc in vitro noncompetitively inhibits the microsomal metabolism of these carcinogens. We have also demonstrated that dietary zinc deficiency is associated with an increased formation of O6-methylguanine in the esophageal DNA of zinc-deficient animals treated with methylbenzylnitrosamine. This increased formation of the mutagenic DNA adduct O6-methylguanine may explain the increased incidence of dialkylnitrosamine-induced carcinomas observed with dietary zinc deficiency. Other trace elements, including molybdenum, selenium, and magnesium, may also alter the incidence of esophageal carcinoma, but studies of these elements are not as conclusive as the epidemiological and experimental studies linking dietary zinc deficiency with an increased incidence of human esophageal carcinoma.     

An internal rate of return approach to investigate pharmacist supply in the united states

Internal rates of return were used to examine the status of pharmacist supply in the United States between the years 1987-1991. Age-earnings profiles were estimated for pharmacists, college graduates and high school graduates. Rates of return to pharmacists and college graduates were compared and a ratio of the pharmacist rate to the college graduate rate was computed for each year. Results suggest a shortage of pharmacists in the United States. Enrollments in pharmacy schools and adopted changes in the training of pharmacists are discussed in relation to their effects on the pharmacist labour market.     

The participation of the united states government in providing financial support for medical education

This paper examines the different issues and topics related to the support of medical education with specific emphasis on federal support. The importance of such an analysis lies in the fact that the current legislation, the Health Professions Educational Assistance Act of 1976 (P.L. 94-484), expires on September 30, 1980. Preparations for new legislation are currently under way. Therefore, discussions, such as those presented in this paper, are appropriate and should be part of the current literature with the hope of generating ideas from potential readers.Education, as developed in the US, has been strongly viewed throughout history as a public right (an inherent individual right) which produces public benefits. A discussion of this issue is presented along with an historical analysis of federal support for higher education, including medical education. The purpose is to establish the case that federal involvement (investment) has been and is at such a level that discontinued support could not be absorbed at the local or state level. Conditions and restrictions of federal support are also included in this section.Another section of the paper discusses the financial structure (sources of support, costs) found in most medical schools with an emphasis on the need for federal support both in terms of the amount and type of aid desired. The major points stressed are related to preserving institutional autonomy, diversity, and integrity and maintaining equality of educational opportunity. Alternative sources and types of financial support are discussed. The paper concludes with a summary of major points leading to the authors' position of continuing, unrestricted federal support for medical education on an institutional basis.     

#85 Association of serum antibodies to the helicobacter pylori caga antigen with precancerous gastric lesions in chinese populations with contrasting gastric cancer rates

PURPOSE: To assess whether serologic markers of Helicobacter pylori infection can account for the differences in prevalence of advanced precancerous gastric lesions (APGL) between two rural Chinese villages.METHODS: We studied asymptomatic adult subjects in Bei Duan village (N = 196) in Linqu County (a high-risk area for gastric cancer) and in Shi Huang village (N = 192) in Cangshan County (a low-risk area for gastric cancer) in Shandong Province, China. Prevalence of APGL was assessed by microscopic examination of endoscopic stomach biopsies. Enzyme-linked immunosorbent assays (ELISA) were used to detect IgG to the H. pylori whole-cell antigen, and to the CagA protein. A logistic regression model was used to quantify the role of the two H. pylori seromarkers in explaining the differences in prevalence of APGL between the two villages, after adjusting for age and sex.RESULTS: The prevalence of APGL was much greater in Bei Duan than in Shi Huang. Although H. pylori seroprevalence by the whole-cell ELISA was similar in the two populations, seroprevalence of CagA was significantly greater in Bei Duan. Although age, sex, and both H. pylori seromarkers were associated with APGL in the logistic regression model, the effect of village of residence remained strong after adjustment for all four covariates.CONCLUSION: Only a relatively small proportion of the variation in prevalence of APGL in the rural Chinese population can be explained by differences in H. pylori seroprevalence, or by differences in CagA seroprevalence.     

白细胞介素8-251基因多态性与胃癌易感性的综合分析

目的 探讨白介素8-251位点(IL8-251)的基因多态性与胃癌易感性的关系.方法 以胃癌组和健康对照组基因型分布的OR值为效应指标,全面检索相关文献,纳入符合人选标准的文献,应用REVMAN 4.2软件对各研究结果进行异质性检验和效应值合并.共纳入文献8篇,纳入数据合并的8项研究累计病例2114例,对照2505例.结果 通过对各研究的(AA+AT)/TT结果的异质性检验得X2值为21.48(P=0.003),随机效应模型计算合并的OR值为1.12(95%CI 0.90～1.40),剔除权重较大的研究后进行的敏感性分析显示其余的各研究同质,固定效应模型的合并OR值为1.21(95%CI 1.06～1.39).结论 携带IL8-251 A等位基因的个体发生胃癌的风险增加.     

Research challenges to the study of HIV/AIDS among migrant and immigrant hispanic populations in the united states

Migrant populations have been found to be at risk of HIV/AIDS. The growth in immigrant and migrant Hispanic populations in the United States increases the need to enhance understanding of influences on their HIV-risk behaviors. Four challenges to conducting research among these populations were identified: (1) the need to use multilevel theoretical frameworks; (2) the need to differentiate between Hispanic subgroups; (3) challenges to recruitment and data collection;, and (4) ethical issues. This article describes how two studies of Hispanic immigrants and migrants in the New York area addressed these challenges. One study focused on new immigrants from Mexico, the Dominican Republic, El Salvador, Honduras and Guatemale, and a second study focused on Puerto Rican drug users. Both studies incorporated qualitative and quantitative methods to study these hard-to-reach populations. Continued study of the sociocultural and contextual factors affecting HIV risk for mobile populations, and addressing the research challenges, is crucial to developing effective intervention programs.     

中美疫苗异常反应救济制度的比较与启示

疫苗接种是一种有益社会的行为,对于因此而遭受异常反应的受害者应由社会给予救济。我国现有的补偿制度有加重政府和企业负担之嫌。借鉴美国的救济制度,在我国建立异常反应损害的基金补偿制度,并使因果关系的认定标准客观化,是实现公平、效率的救济目标的重要途径。