ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Alcohol has strong antimicrobial activity and stimulates gastric acid secretion. Alcohol consumption may therefore compromise the living conditions ofHelicobacter pyloriin the stomach. We assessed the relation of alcohol consumption withH. pyloriinfection among 1,785 participants ages 18–88 in the German National Health and Nutrition Survey. Detailed information on dietary and lifestyle habits was obtained in personal interviews using a standardized food frequency questionnaire. Serum samples were analyzed forH. pyloriimmunoglobulin G antibodies by enzyme-linked immunosorbent assay. Overall prevalence ofH. pyloriinfection was 39.2%. There was a clear inverse dose-response-relation between reported alcohol consumption andH. pyloriinfection. The relation persisted after control for potential confounding factors. The adjusted prevalence ratios (95% confidence intervals) forH. pyloriinfection among persons who consumed up to 10, 10 to 20, and more than 20 gm of alcohol per day compared with non-drinkers were 0.93 (0.77–1.13), 0.82 (0.65–1.04), and 0.71 (0.55–0.92). The inverse relation between alcohol consumption andH. pyloriinfection was even stronger when individuals with an indication of a recent change of alcohol consumption were excluded from the analysis. These findings support the hypothesis that moderate alcohol consumption may facilitate spontaneous elimination ofH. pyloriinfection among adults. (Epidemiology 1999;10:214–218)

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The objective of this study was to assess the effectiveness ot a hygiene program in reducing the incidence of respiratory and diarrheal diseases in toddlers attending day care centers. A randomized field trial was conducted in 52 day care centers in Québec, Canada, between September 1, 1996 and November 30, 1997. Absences for any reasons and the daily occurrence of colds and/or diarrhea in toddlers were recorded on calendars by the educators. The number of fecal coliforms on children's hands and on educators' hands was measured during three unannounced visits. Overall, 1,729 children were followed in 47 day care centers for a total of 153,643 child-days. The incidence rate of diarrhea was considerably reduced by the effect of monitoring (IRR = 0.73, 95% CI = 0.54,0.97), and the intervention reduced the incidence rate of upper respiratory tract infections (IRR = 0.80, 95% CI = 0.68,0.93). Monitoring alone also had an important effect in reducing the level of bacterial contamination on children's and educators' hands. The results indicate that both an intervention program and monitoring alone play a role in reducing infections in children attending day care centers. (Epidemiology 1999;10:219–227)

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We studied the recurrence of upper gastrointestinal bleeding (UGIB) in a cohort of patients who had an episode of peptic ulcer bleed, and we investigated the effect of maintenance treatment with cimetidine, omeprazole, and ranitidine. We identified 952 patients with a hospitalization for an episode of peptic ulcer bleed by searching the General Practice Research Database in the United Kingdom. The mean follow-up time was 33 months. Less than 10% of the cohort presented with a new episode of UGIB. We calculated incidence rates of recurrent UGIB and estimated the relative risk (RR) of UGIB associated with use of the various acid-suppressing drugs. The greatest protection for recurrent UGIB associated with maintenance acid-suppressing treatment was seen with omeprazole (relative risk 0.2; 95% CI, 0.02–1.0). The corresponding estimates with cimetidine and ranitidine were 0.9 (0.3–2.3) and 0.9 (0.5–1.8). Among nonsteroidal anti-inflammatory drug users, concomitant use of omeprazole afforded protection against a new bleed (RR 0.0; 0.0–1.0), and there was a suggestion of a protective effect with misoprostol, 0.4 (0.01–3.2). The degree of lowered risk of recurrent UGIB in patients on omeprazole maintenance therapy compared with cimetidine or ranitidine therapy is comparable with the protection provided through profound reduction of gastric acidity achieved with proton-pump inhibitors. (Epidemiology 1999;10:228–232)

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We conducted a retrospective cohort study to evaluate the relation between the level of total trihalomethanes in drinking water and adverse birth outcomes. The study population comprised women residing in an area with municipal surface water who had a singleton birth in Nova Scotia between January 1, 1988, and December 31, 1995, or a pregnancy termination for a major fetal anomaly. We found little association between trihalomethane level and the outcomes related to fetal weight or gestational age, but we found an elevated relative risk for stillbirths for average trihalomethane levels during pregnancy of 100 μg/liter or greater (adjusted relative risk = 1.66; 95% confidence interval = 1.09–2.52) relative to women exposed to trihalomethane levels of 0–49 μg/liter. We saw little evidence of an elevated prevalence or dose-response pattern for congenital anomalies, with the possible exception of chromosomal abnormalities (adjusted prevalence ratio = 1.38 and 95% confidence interval = 0.73–2.59 for women exposed to trihalomethane levels of 100 μg/liter or greater). (Epidemiology 1999;10:233–237)

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We compared four methods of control selection to assess the effect of using infants with malformations as controls in case-control studies of birth defects. We identified cases and controls using data from the Slone Epidemiology Unit Births Defect Study for the years 1976–1992. Cases were defined as infants with cleft lip and palate and no other malformations (N = 494). Controls (N = 8356) were chosen from infants with other malformations, excluding other oral cleft conditions or syndromes associated with clefts. Maternal smoking during the first 13 weeks of pregnancy was the exposure of interest. We then assessed the measures of association resulting from using controls with varying restrictions. When we excluded all defects potentially associated with maternal smoking (based on reports in the literature), the crude odds ratio for smoking and oral cleft risk was 1.6 (1.3–1.9). When we eliminated all defect groups with a smoking prevalence that was one or more standard deviations above or below the total control group mean, the odds ratio was 1.5 (1.2–1.8); with controls restricted to infants with Mendelian-inherited disorders (with presumably no causal effect of smoking), the odds ratio was 1.6 (1.1–2.7); and when selection was unrestricted, the crude odds ratio was 1.5 (1.2–1.8). When used selectively, infants with malformations other than the anomaly of interest can be a suitable source of controls. (Epidemiology 1999;10:238–241)

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Because of concern about the potential adverse effects of consuming caffeinated beverages during pregnancy, pregnant women may choose to replace caffeinated with decaffeinated coffee. In a population-based study of 7,855 livebirths in California's San Joaquin Valley, we examined the relation of maternal decaffeinated and caffeinated coffee consumption during pregnancy to measures of fetal growth and gestational duration. Mothers answered a questionnaire in the hospital at the time of completing the birth certificate. Compared with women who drank neither decaffeinated nor caffeinated coffee, those who consumed only decaffeinated coffee showed no increased odds of small-for-gestational age birth, low birth weight, or preterm delivery, nor lowered mean birth weight or shortened mean gestational age. Women who consumed caffeinated coffee alone had an adjusted odds ratio of 1.3 [95% confidence limits (CL) = 1.0, 1.7] for preterm delivery, whereas those who consumed both caffeinated and decaffeinated coffee had an adjusted odds of 2.3 (95% CL = 1.3, 4.0). When caffeinated and decaffeinated coffee were considered as continuous variables, we found a reduction in adjusted mean birth weight of −3.0 gm per cup per week (95% CL = −5.9, −0.6) for caffeinated coffee and an increase of +0.4 gm per cup per week (95% CL = −3.7, 4–5) for decaffeinated coffee. (Epidemiology 1999;10:242–249)

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

We examined the effects of short interpregnancy intervals on small-for-gestational age and preterm births in a biracial population using North Carolina birth certificate data from 1988 to 1994. We defined small-for-gestational age birth as being below the 10th percentile on a race-, sex-, and parity-specific growth curve after a gestation of 37–42 weeks. We defined preterm birth as a gestation of less than 37 weeks. We analyzed birth records from all eligible singleton births to black or white women ages 15–45 years after an interpregnancy interval of 0–3 months (N = 11,451) and a random sample of singleton births after an interval of 4–24 months (N = 23,118). We defined interpregnancy interval exposure categories as 0–3, 4–12, and 13–24 months. The multivariate adjusted odds ratio for small-for-gestational age births after interpregnancy intervals of 0–3 months compared with 13–24-month intervals was 1.6 (95% confidence interval = 1.4–1.8). The odds ratio for preterm birth after interpregnancy intervals of 0–3 months was 1.2 (95% confidence interval = 1.1–1.3). Odds ratios did not vary substantially by race for either outcome. (Epidemiology 1999;10:250–254)

ISSN:1044-3983    

出版商:OVID    

年代:1999

数据来源: OVID