Childhood precursors of age at first intercourse for females

Age at first intercourse for a sample of adult white women using variables measured during childhood is predicted. Childhood predictors were measured at birth, and ages 5 and 9–11, using existing public-use data on the women. Median age at first intercourse for the sample was 17.5 years. Early family predictors, early developmental characteristics, and temperamental characteristics during childhood together could predict about a fourth of the variance in age at first intercourse. The strongest predictors were motor skills and nightmares at age 5, church attendance with family at age 9, and domineering and mature personality at age 9.This research was supported by grants R01-HD23454 and P30-HD05798 from the National Institute of Child Health and Human Development. An earlier version of this paper was presented at the annual meetings of the Population Association of America, Denver, Colorado, April 30–May 2, 1992.     

The significance of an isolated central nervous system relapse, occurring as first relapse in children with acute lymphoblastic leukemia

In a retrospective study, which comprised the whole Dutch childhood population of approximately 3 million children, the authors assessed the influence of an isolated meningeal relapse, occurring as first relapse, together with some patient and treatment characteristics on prognosis in 142 children with acute lymphoblastic leukemia (ALL). Until their first relapse, patients were initially treated according to standard protocols, whereas the treatment for relapse was heterogeneous. Concerning the probability of achieving a second complete remission (CR) it appears that the duration of the first CR is the single most important prognostic factor. The duration of the first CR is also the most important factor with regard to the duration of the second CR, upon which also age and sex have a significant influence. Concerning the survival from the time of central nervous system (CNS) relapse, again the duration of the first CR appears to be the most important prognostic factor, followed by age and the institution of systemic reinduction treatment. Other factors, such as initial leukocyte count, attainment of first CR within 48 days, type of reinduction treatment, and the cerebral spinal fluid (CSF) blast count at the time of relapse, have a less important, but nevertheless significant influence on survival. The median survival from the time of CNS relapse is 25 months, the 5-year survival is 25%, whereas the ultimate survival will be less than 20%. From 90 patients who developed second or subsequent relapses, 75% experienced a bone marrow relapse during the follow-up period. From this study the authors conclude that CNS relapse in children with ALL carries a grave prognosis, which requires the institution of intensive retreatment programs.     

Gender differences in cardiovascular risk factors in a carotid endarterectomy population.

AIM: Present knowledge about the epidemiology and the distribution of the cardiovascular risk factors of carotid artery atherosclerosis is limited. The aim of the study was to detect possible gender differences in cardiovascular risk factors in carotid endarterectomy patients. METHODS: Between 1998 and 2003 the cardiovascular risk factors of 804 consecutive isolated carotid endarterectomies were prospectively recorded. The data of 567 men and 237 women were compared and subgroup analysis of young and old male and female subjects was performed. RESULTS: The number of cardiovascular risk factors per patient is higher in men, hypertension is more predominant in women, tobacco use is twice as often present in men. The most frequent risk factors are, in men, tobacco use and hypertension, and, in women, hypertension and hyperlipidemia. The most frequent combination in the male group is tobacco/hypertension/hyperlipidemia and in the female group hypertension/hyperlipidemia. The gender differences were more striking in patients younger than 75 years, after this age the number of cardiovascular risk factor per patient declined in both sexes, the number of smokers decreased but remains higher in men, diabetes is more frequent in women and hypertension and hyperlipidemia become the important risk factors in men as well in women. CONCLUSIONS: There are gender differences in the distribution and in the combinations of cardiovascular risk factors in our selected patients. These findings suggest that screening for carotid artery atherosclerosis should particularly be aimed at people with the combinations of risk factors described above.     

Amputation in elderly and high-risk vascular patients

Fifty-eight patients underwent lower limb amputation for arterial disease over a 30-month period. Mean age of the patients was 72 years. Cardiopulmonary and metabolic risk factors were present in the majority of the patients. Postoperative one-year and three-year mortality rates were 24, 40, and 76%, respectively. Contralateral amputation was required in one-third of the patients after a mean period of eight months. Only younger and healthier patients returned to a meaningful social life after appropriate prosthetic fitting. In view of the high mortality and morbidity rates, above-knee amputation seems a better choice than below-knee amputation in these elderly and high-risk patients.     

Dual-energy X-ray absorptiometry of lumbar vertebrae: relative contribution of body and posterior elements and accuracy in relation with neutron activation analysis.

The bone mineral content of 34 lumbar vertebrae obtained from ten cadavers (three men, seven women; age 61-88 years) was measured using a pulsed source dual-energy X-ray absorptiometry (DEXA) apparatus. Scanning was performed in the frontal projection and was repeated on the vertebral bodies obtained after removal of the posterior elements of the vertebrae. Subsequently a nondestructive neutron activation analysis (NAA) was performed. The mineral content of the vertebral bodies was found to represent (mean, SEM) 53.0% (1.9%) of the content of the whole vertebrae. The mineral content of the vertebral bodies assessed with NAA (BMC NAA) and with DEXA (BMC DEXA) showed a high correlation: BMC NAAA = (1.016 x BMC DEXA) + 0.990 r = 0.949 (p less than 0.001). We conclude that the mineral content of lumbar vertebral bodies can be accurately measured in vitro in a water environment by DEXA, and that the mean contribution of the posterior elements of the vertebra to the calcium hydroxyapatite content of whole vertebrae measured in the frontal projection is as high as 47.0%.     

Lung cancer: is there an association with socioeconomic status in The Netherlands?

STUDY OBJECTIVE--To evaluate if there are differences in lung cancer incidence between socioeconomic groups in the Netherlands and if so, if smoking habits and other lifestyle characteristics could explain these differences. DESIGN--Prospective cohort study. Baseline measurement included information on socioeconomic status, smoking habits, and other covariates by means of a self-administered questionnaire. Follow up was established by computerised record linkage to cancer registries and a pathology register. SETTING--Population originating from 204 municipalities in The Netherlands. PARTICIPANTS--58,279 men aged 55-69 years in September 1986. After 3.3 years of follow up 490 microscopically confirmed incident lung cancer cases were detected. MAIN RESULTS--An inverse association between lung cancer risk and highest level of education was found, which persisted after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol (rate ratio (RR) highest/lowest level of education = 0.52, 95% CI 0.33, 0.82, trend p < 0.001). Men with a lower white collar profession had a significantly lower relative rate of lung cancer compared with blue collar workers (RR = 0.66, 95% CI 0.47, 0.96), but after adjustment for smoking habits this difference was reduced (RR = 0.73, 95% CI 0.51, 1.08). CONCLUSIONS--There is an inverse association between highest level of education and lung cancer, which is still apparent after adjustment for age, smoking, dietary intake of vitamin C, beta-carotene and retinol. The significantly lower lung cancer risk of lower white collar workers compared with the risk of blue collar workers could be partially explained by smoking habits.     

Cerebral involvement in children with acute and relapsing inflammatory polyneuropathy

We present two children with seizures and other signs of cerebral involvement at the outset of acute inflammatory demyelinating polyneuropathy, consistent with a diagnosis of encephalomyeloradiculoneuropathy. One child had a recurrence associated with mild central dysfunction and improved during therapy with corticosteroids. Both children recovered completely. Both acute and relapsing inflammatory demyelinating neuropathy may be accompanied by cerebral dysfunction, expanding the clinical spectrum of encephalomyeloradiculoneuropathy.     

A 12 year follow up study in the general population on prognostic factors of cartilage loss in osteoarthritis of the knee.

The natural history and prognostic factors of cartilage loss in osteoarthritis of the knee were studied in subjects from a general population survey on rheumatic diseases in 1975-8. Baseline data were collected by questionnaire, physical examination, and weightbearing anteroposterior knee radiographs. Follow up of the subjects aged 46-68 years with radiological osteoarthritis grade 2-4 (Kellgren) took place in 1988-9. Cartilage loss was assessed by two observers who scored the change in joint space width between two radiographs. Thirty four per cent had cartilage loss. Prognostic factors and adjusted odds ratios (ORs) (95% confidence intervals) were: body mass index OR = 11.1 (3.3 to 37.3) fourth v first quartile; body weight OR = 7.9 (2.6 to 24.0) third v first tertile; age OR = 3.8 (1.1 to 13.4) > 60 v < or = 49 years; Heberden's nodes OR = 6.0 (1.5 to 23.1); clinical diagnosis of generalised osteoarthritis OR = 3.3 (1.3 to 8.3); and previous bow legs or knock knees OR = 5.1 (1.1 to 23.1). The relation of age with cartilage loss was also confounded by the presence of Heberden's nodes or a diagnosis of generalised osteoarthritis. There was no statistically significant relation for gender, meniscectomy, injury, uric acid concentration, chondrocalcinosis, smoking, and occupation related factors, except possibly standing.     

Keratin and vimentin distribution patterns in the epithelial structures of the cannie anal region

The intermediate filament labeling pattern of the epithelial structures of the canine anal region was studied with different polypeptide specific keratin monoclonal antibodies (MoAbs) and with a monoclonal and polyclonal vimentin antibody. The epithelial structures in this region could be discriminated and characterized by differences in their keratin staining pattern. The basal cells in the different epithelial structures showed a similar staining pattern characterized by reactivity with MoAbs staining keratins 5, 8, 14, and 17. Columnar epithelial cells showed a completely different phenotype mostly characterized by reactivity with MoAbs staining keratins 7, 5, 8, 18, and 19. A restricted number of differentiated perianal gland cells showed perinuclear vimentin staining. Myoepithelial cells did not stain for vimentin, but, as other basal cells, were positive for MoAbs staining keratins 5, 8, 14, and 17.© Willey-Liss, Inc.