Prospective cohort study of antioxidant vitamin supplement use and the risk of age-related maculopathy

In a prospective cohort study, the authors examined whether self-selection for antioxidant vitamin supplement use affects the incidence of age-related maculopathy. The study population consisted of 21,120 US male physician participants in the Physicians' Health Study I who did not have a diagnosis of age-related maculopathy at baseline (1982). During an average of 12.5 person-years of follow-up, a total of 279 incident cases of age-related maculopathy with vision loss to 20/30 or worse were confirmed by medical record review. In multivariate analysis, as compared with nonusers of supplements, persons who used vitamin E supplements had a possible but nonsignificant 13% reduced risk of age-related maculopathy (relative risk = 0.87, 95 percent confidence interval (CI) 0.53-1.43), while users of multivitamins had a possible but nonsignificant 10% reduced risk (relative risk = 0.90, 95% CI 0.68-1.19). Users of vitamin C supplements had a relative risk of 1.03 (95% CI 0.71-1.50). These observational data suggest that among persons who self-select for supplemental use of antioxidant vitamin C or E or multivitamins, large reductions in the risk of age-related maculopathy are unlikely. Randomized trial data are accumulating to enable reliable detection of the existence of more plausible small-to-moderate benefits of these agents alone and in combination on age-related maculopathy.     

Tobacco-use reduction among high-risk youth: recommendations of a National Cancer Institute Expert Advisory Panel

The National Cancer Institute's efforts to prevent tobacco-related cancers have resulted in numerous activities to reduce smoking prevalence throughout the United States. Two decades of research activity has provided much of the information needed for interventions through channels such as mass media, physician/dentist training, self-help strategies, and school-based prevention programs. However, in the area of adolescent tobacco-use reduction, it has been consistently observed that youth who have the highest tobacco-use rates are among those least likely to be reached through school-based or other programs. Thus, these youth, often labeled "high-risk," are seen as a cornerstone for tobacco use prevention efforts. Although they pose a particularly difficult access problem, many valuable recommendations for strategies to identify and reach this group were made by a recent NCI-convened Expert Advisory Panel on the Prevention and Cessation of Tobacco Use by High-Risk Youth. The Panel considered this issue from three perspectives--methods of identifying these youth, strategies for reaching them with appropriate tobacco-use prevention/cessation programs, and identification of research needs. Their recommendations and conclusions are summarized in this article. Support for research addressing the prevention and cessation of tobacco use among high-risk youth is currently being considered by the NCI.     

Cadmium absorption in mice: effects of broiling on bioavailability of cadmium in foods of animal origin

The absorption and organ distribution of organic Cd from raw and broiled horse kidney was compared to that of CdCl2 at two dose levels (0.05 and 3 mg Cd/kg feed) in a feeding study in mice. The high Cd concentration in the horse kidney (raw 112 mg/kg; broiled 53 mg/kg) made it possible to mix kidney into mouse feed without marked effects on the composition of the feed. The weight of the mice, feed and water consumption, and Cd levels in the feed were determined once a week. After 9 wk of exposure, the liver and kidneys of the mice were sampled and Cd was analyzed. The Cd concentration in horse kidney was halved by broiling, and the content of soluble Cd decreased from 12% in raw kidney to 5% in broiled kidney. The majority of the soluble Cd was associated with proteins with the same molecular weight as metallothionein (MT) in both raw and broiled kidney. Broiling of the kidney had no marked effect on the fractional accumulation of organic Cd in mice. The fractional accumulation of inorganic CdCl2, on the other hand, was significantly higher than that of organic Cd in the low dose groups but not in the high dose groups. The ratio between Cd accumulation in kidney and that in liver was higher in the group receiving raw kidney compared to the ratio in the group receiving CdCl2 at both the high and low exposure levels. This indicates that the raw kidney contained a Cd form that was more preferentially distributed to the kidneys.     

Long-term efficacy of argon laser trabeculoplasty

Long-term efficacy of 360 degrees argon laser trabeculoplasty was studied in 118 eyes of 93 patients with uncontrolled chronic open-angle glaucoma. The mean intraocular pressure (IOP) decrease was 8.9 +/- 5.4 mmHg (mean +/- standard deviation [SD] in 71 eyes at 1 year, 9.3 +/- 4.3 mmHg (mean +/- SD) in 51 eyes at 3 years, and 10.3 +/- 3.9 mmHg (mean +/- SD) in 28 eyes at 5 years. The probability of success at 4 years (decrease in IOP greater than or equal to 3 mmHg, IOP less than or equal to 19 mmHg, stable visual field, stable optic nerve, and no further laser or surgical intervention) was 52%. Pretreatment IOP, diagnosis, previous operations, age, and sex were not significant determinants for success or failure. Eyes receiving argon laser trabeculoplasty before cataract surgery maintained control of IOP after surgery. Failure was most common in the first year after treatment (23%), and thereafter failure occurred at a rate of 7 to 10% per year.     

Complementary Public Service Announcements as a Strategy for Enhancing the Impact of Health-Promoting Messages in Fictional Television Programs

Research suggests that health-promoting storylines in developed nations’ fictional television programs can have a beneficial impact on viewers’ beliefs, attitudes, intentions, or behaviors. The sizes of the effects are generally modest; however, the audience reach is substantial. Given that many fictional programs may hold the prolonged attention of millions of viewers, it is of value to examine potential strategies for enhancing the persuasive impact of their health-promoting storylines. Complementary public service announcements may be a promising strategy. This randomized experimental study (N = 310) examined the effects of viewing a complementary public service announcement after an organ donation story in an episode of Grey’s Anatomy. Results indicated that the public service announcement enhanced the beneficial impact of the story on viewers’ discussion behavior (about one’s organ donor wishes), discussion intention, and perceived learning. This experimental study is the first to examine the effects of viewing a non-character public service announcement after a health-related storyline in a developed nation’s fictional program compared to viewing the same episode of the program on its own. It is important for future research to examine whether these findings replicate for different health issues and with a nationally representative sample.     

CONCENTRATION-DEPENDENT ABSORPTION OF ALUMINUM IN RATS EXPOSED TO LABILE ALUMINUM IN DRINKING WATER

The hypothesis was tested that the absorption of labile Al in rats will increase when the Al-binding capacity of food components in the stomach is saturated. Male rats were exposed to 0, 10, 50, or 500 mg labile Al/L in acidic drinking water (pH 3) for 9 wk. The results show that labile Al in drinking water is complexed by feed constituents in the stomach of the rat in vivo, thus causing a nondetectable absorption of Al at 10 mg Al/L. An increased absorption of Al at 50 and 500 mg Al/L was associated with a saturation of the Al-binding capacity of feed components in the lumen of the stomach, causing the appearance of labile Al. Thus, the presence of labile Al in drinking water does not necessarily result in a high Al absorption when the water is ingested, since the bioavailability of labile Al is dependent both on the amount and composition of Al-binding components present in the gastrointestinal tract at the time of ingestion of the water. It is thus not possible to predict the body burden of Al in humans just by measuring the Al concentrations in drinking water. Even a further refining of the exposure measurement to include speciation of Al in the water may not markedly improve the prediction of the Al body burden. Future epidemiological studies must therefore be based on actual measurements of Al concentration in tissues or fluids from the study subjects.     

Efficacy and safety of timolol for prevention of supraventricular tachyarrhythmias after coronary artery bypass surgery

Forty-one patients undergoing coronary artery bypass grafting were randomly assigned to receive prophylactic timolol or placebo, given in a double-blind fashion. beta-Adrenoceptor-blocking therapy was stopped at least one half-life before surgery. Three to 7 hr after surgery (304 +/- 56 min), 0.5 mg of timolol or placebo was given intravenously twice daily in a double-blind manner. When oral medications were resumed postoperatively, 10 mg of timolol twice daily or placebo was continued orally. Continuous electrocardiograms were recorded for 24 hr before and for 7 days after surgery with a standard cassette recorder. No patient received digoxin. Both groups were comparable for frequency of preoperative supraventricular arrhythmias, left ventricular ejection fraction, duration of cardiopulmonary bypass, aortic cross-clamp time, number of bypass grafts, and total duration of monitoring. Analysis of arrhythmias was done by hand counts, and supraventricular arrhythmias were divided into supraventricular tachycardia and atrial fibrillation and/or flutter. Timolol decreased the frequency of supraventricular tachycardia (581 episodes placebo vs 84 timolol; p less than .05) and of atrial fibrillation and/or flutter (291 episodes placebo vs five timolol; p less than .05). Timolol decreased the number of patients with severe (heart rate greater than 200 beats/min, duration greater than 50 beats) episodes of supraventricular tachycardia (four placebo vs 0 timolol; p less than .05) and also decreased the number of episodes of severe (heart rate greater than 200 beats/min, duration greater than 5 min) atrial fibrillation and/or flutter (16 placebo vs one timolol; p less than .005). There were differences in the durations of supraventricular arrhythmias.(ABSTRACT TRUNCATED AT 250 WORDS)