摘要:

The decisive conclusions to be drawn from the geography and prevalence of MS are: (1) a north-south (as well as west-east in the United States) gradient exists independent from genetic/racial factors; (2) major differences in prevalence occur in the absence of difference in latitude; (3) individuals from the same ethnic derivation have either the similar prevalence or have very different prevalence rates in widely separated geographical areas, and (4) specific resistant isolates are shown to exist regardless of latitude. Existing prevalence information leads to the almost inescapable conclusion that the geography of MS cannot be explained by any single known environmental or genetic factor(s) in isolation. A combination of a heterogeneous distribution of both genetic and environmental factors appears to be required to explain the available data on MS and geography.

ISSN:0251-5350    

DOI:10.1159/000110293

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The etiology of multiple sclerosis (MS) remains unknown despite considerable research involving a number of disciplines for many decades. Cluster analysis was used to disentangle the possible heterogeneity of MS, based on clinical characteristics of 108 subjects. Further on, a case-control study was conducted within each subgroup found with the cluster analysis, to test with more validity environmental risk factors, such as alcohol, tobacco, medication and drug abuse. The controls with a rheumatoid arthritis condition were matched to the cases on age, gender and same postdiagnostic period and were recruited from the same hospital. Three main groups of MS subjects were obtained from the cluster analysis, distinguished by the gender, the presence or not of family history and the degree of severity of their physical disability. The results showed that drug abuse was the only risk factor with a statistically significant odds ratio for overall and for the unique female group without familial history of MS.

ISSN:0251-5350    

DOI:10.1159/000110294

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

In a previous study we analyzed the possible relationship between dairy product consumption and multiple sclerosis (MS) worldwide. We showed that a good correlation (Spearman rank ρ = 0.836), statistically strongly significant (p < 0.0001), existed between liquid cow milk consumption and MS prevalence. The interpretation of this strong correlation between MS and milk consumption is still unclear: fresh milk could be considered as a cofactor, but it could also reflect a much stronger association with MS of another unstudied factor, well correlated with milk consumption (yet, this is not the case for latitude). Obviously, the bovine population in each country and, particularly milk cows, has to be considered. In the present study, we analyze the correlations existing between the figures of national, cow milk production and MS prevalence in 20 countries. We also analyze the correlations with the whole bovine, ovine, caprine, porcine, horse, poultry, cat and dog populations. Here again we find significant correlations between (i) cow milk production per inhabitant, (ii) national bovine density per inhabitant, and (iii) local bovine geographic density, and MS prevalence. However, these correlations are relatively weaker than that found with fresh liquid milk consumption in our previous study. No correlation is found with other farm animals or with pets in the same countries. The epidemiological significance of these results, suggesting a preponderant role of fresh cow milk, is discussed

ISSN:0251-5350    

DOI:10.1159/000110295

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

We investigated the relationship between animal product consumption and evidence of dementia in two cohort substudies. The first enrolled 272 California residents matched for age, sex, and zip code (1 vegan, 1 lacto-ovo-vegetarian, and 2 ''heavy'' meat eaters in each of 68 quartets). This design ensured a wide range of dietary exposure. The second included 2,984 unmatched subjects who resided within the Loma Linda, California area. All subjects were enrolled in the Adventist Health Study. The matched subjects who ate meat (including poultry and fish) were more than twice as likely to become demented as their vegetarian counterparts (relative risk 2.18, p = 0.065) and the discrepancy was further widened (relative risk 2.99, p = 0.048) when past meat consumption was taken into account. There was no significant difference in the incidence of dementia in the vegetarian versus meat-eating unmatched subjects. There was no obvious explanation for the difference between the two substudies, although the power of the unmatched substudy to detect an effect of ''heavy'' meat consumption was unexpectedly limited. There was a trend towards delayed onset of dementia in vegetarians in both substudies.

ISSN:0251-5350    

DOI:10.1159/000110296

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The Copenhagen City Heart Study is a prospective study based on a randomly selected sample of an urban population of, initially, 19,698 participants followed since 1976. Risk factor analysis was based on the initial examination of 13,000 persons ≧35 years old without previous stroke who responded to the first invitation. In the period 1976–1988, 696 initial cases were identified: 584 strokes, 106 transient ischemic attacks and 6 retinal-artery occlusions. We used the regression model of Cox based on a hierarchic system of risk factors that indicated the way they influence each other. This method distinguishes independent risk factors and estimates their causal influences on the risk of stroke. Among the basic variables analyzed in this paper, significant effects were found for age, sex, length of school education and income. There was a tendency for living alone to be a risk factor as opposed to living with someone, while no influence could be demonstrated for family history of str

ISSN:0251-5350    

DOI:10.1159/000110297

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

The objective of the present work was to identify independent life-style factors for stroke and to estimate their causal contribution. The study is based on a random sample of the Copenhagen population selected in 1976 and stratified by age. The present analysis includes 12,961 subjects examined initially, aged 35 or over and without a previous cerebrovascular event, for whom information about life-style factors was recorded between 1976 and 1978. The outcome was the first-in-life stroke or transient ischemic attack during 12 years of follow-up. The events were ascertained at a second examination 5 years later and from hospital records and death certificates through 1988. Cox''s regression model was used to estimate the effect on stroke risk of the factors recorded. In the period 1976–1988, 693 initial events were recorded in eligible responders. Among the life-style factors analyzed, a significant, independent effect was found for cigarette smoking, daily consumption of sleeping pills or tranquilizers and body mass index (BMI). There was a tendency for daily alcohol intake to be associated with lower risk, this could not be demonstrated for physical activity at leisure time. Among smokers, stroke risk was influenced by the number of cigarettes smoked, and daily alcohol intake was associated with a significantly lower risk. The effect of smoking decreased with age. BMI in smokers still had a significant effect on stroke risk but neither daily consumption of tranquilizers, nor physical inactivity at leisure time had a significant influenc

ISSN:0251-5350    

DOI:10.1159/000110298

出版商:S. Karger AG    

年代:1993

数据来源: Karger

摘要:

For general practitioners and in epidemiological studies, migraine poses diagnostic problems. It is a polymorphous disease, with diagnosis based on a subjective description of symptoms. The International Headache Society (IHS) proposed a set of rigorous criteria for the diagnosis of migraine. We studied its validity on 171 outpatients of headache clinics and on 96 headache sufferers detected during an annual checkup for workers. The criteria showed an excellent specificity, however sensitivity in both samples was <50%. This lack of validity could be due to IHS criteria being too restrictive. We therefore elaborated and validated our own diagnostic tool, based on the IHS criteria, to a sensitivity of 95% and a specificity of 78%. We propose our tool for epidemiological studies.

ISSN:0251-5350    

DOI:10.1159/000110299

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000110300

出版商:S. Karger AG    

年代:1993

数据来源: Karger

ISSN:0251-5350    

DOI:10.1159/000110301

出版商:S. Karger AG    

年代:1993

数据来源: Karger