In Norsjö in Northern Sweden a cardiovascular intervention programme, for adults is presently tested. The aim of the present study was to investigate the presence of factors related to cardiovascular disease in all 15-year-old adolescents living in Norsjö in 1987 and 1988. The total cholesterol concentration in serum, as an average for the test period, was 4.2 mmol/l and 4.7 mmol/l for boys and girls, respectively. Fourteen per cent of the boys and 32% of the girls had a total cholesterol concentration exceeding 5 mmol/l. Twenty-seven per cent of the adolescents had high values for two or more variables related to risk of developing cardiovascular disease. The evaluation of the dietary registrations showed unsatisfactory values for fibre, P/S ratio and total fat. The dietary habits were better in the 15-year-olds in 1988 than in 1987 as judged by significantly higher average daily intake of fibre as well as a higher content of fibre per megajoule in the food.
A variety of anthropometric measurements was made in a randomized population sample of middle-aged women in five age strata in whom body composition was estimated from total body potassium and total body water determined by whole body counting and isotope dilution technique, respectively. No significant differences with age were found for total body potassium or total body water. A significant age difference was found for body fat mass. Simple linear correlations between anthropometric variables and body fat mass estimates were found to be 0.90, 0.86, 0.77 for body weight, buttock circumference, and sum of triceps and subscapular skinfold thicknesses, respectively. Multiple regression analysis showed that these three variables accounted for 80 to 91% of the variation in body fat in the different age strata studied. Multiple regression equations for prediction of body fat from anthropometric variables are given. In about two-thirds of the subjects, the difference between predicted body fat mass and estimated body fat mass was found to be less than +/- 2.5 kg.
To examine the outcome of cochlear implantation in children with syndromic deafness, who are increasingly being considered for cochlear implants and who represent a unique challenge to the cochlear implant team.
In this retrospective case series in a tertiary referral cochlear implant centre, we describe a series of 38 children with a clinical syndrome causing deafness who have undergone cochlear implantation. The outcome measures are Bench-Kowal-Bamford (BKB) speech reception score (range 0-100%) and speech perception ability using the Geers and Moog Speech Reception Score (SRS) (range from 0; no speech perception, to 6; open set recognition of words).
The syndromes identified were Waardenburg syndrome (n = 10), Usher syndrome (n = 9), Pendred syndrome (n = 7), Jervell and Lange-Nielsen syndrome (n = 5), CHARGE syndrome (n = 2), and 1 each of Stickler, CINCA (Chronic Infantile Neurological Cutaneous and Articular), Bartter, Down, and Donnai-Barrow syndromes. After a minimum of 19 months following implantation, BKB was measurable in 20 of 38 patients, and ranged from 46 to 100% in quiet (median 87%, mean 81%). Eighteen children (55%) achieved a SRS at level six, and a further 8 (24%) achieved level five. There was significant variation of outcome between and within syndrome groups.
Additional disabilities are frequently encountered when considering children for cochlear implantation, and may be part of a recognised syndrome. Outcome is often excellent but can be variable even within the same syndrome group, and such children are therefore assessed on an individual basis to ensure a realistic expectation.
Donnai-Barrow syndrome is a rare autosomal recessive disorder associated with severe sensorineural hearing loss (SNHL). Several ocular abnormalities have also been described in this syndrome, including hypertelorism, down-slanting palpebral fissures, myopia and retinal detachment. The condition is also associated with diaphragmatic hernia, exomphalos, absent corpus callosum and developmental delay. We describe the first recorded case of cochlear implantation in this rare disorder.
This case of Donnai-Barrow syndrome was identified from our paediatric cochlear implant database. A case-note review was performed identifying patient demographics, operative findings and surgical outcome. In addition, pre- and post-operative auditory and communication performance was analysed.
The child initially received a right cochlear implant at 39 months of age, but unfortunately the device failed 4 years post-operatively. Subsequently, bilateral simultaneous cochlear implantation was performed. BKB scores were 98% for bilateral implant use when tested 2 years post-operatively. Individual testing revealed a score of 94% for the right ear alone, and 80% for the left. The child achieved a 100% score on sound localisation testing using 3 speakers.
Donnai-Barrow syndrome is a rare cause of SNHL compounded by the potential for visual impairment. To our knowledge this is the first report of cochlear implantation to rehabilitate hearing loss in this condition.
BACKGROUND: We describe an epidemiologic analytical study of the relationship between current diet and breast cancer risk. METHOD: The study design is a case-control analysis. Cases were recruited from a mammography screening program used within the national health care system; the control subjects were selected from subjects free of breast cancer in the same population. A total of 380 cases and 525 control subjects, frequency-matched for age, month of mammography, and county of residence, were identified. Of these, 265 cases and 432 control subjects were included in this analysis. Odds ratios for breast cancer in relation to food and nutrient intake were the main outcome measures. RESULTS: Exposure in the highest quartile of beta-carotene intake gave an odds ratio of 0.6 (95% confidence interval, 0.4 to 1.0). No increased risk was noted with high fat intake. Breast cancer risk was associated with alcohol intake only when alcohol was analyzed in quartiles: odds ratio, 1.6 (95% confidence interval, 1.0 to 2.4) for the highest quartile of intake vs the lowest. Stratified analyses showed that a high fat intake might decrease the protective effect of beta-carotene intake. Risks did not change appreciably with adjustment for total energy intake or known breast cancer risk factors. CONCLUSIONS: As in most other studies, no strong risk factors for breast cancer have been identified in the current diet. The negative association between breast cancer risk and beta-carotene intake may be supported by a plausible mechanism, but our finding concerning alcohol should be interpreted cautiously since there was no dose-response relationship and the biological mechanism for a threshold effect at very low levels of consumption is unclear.
Dietary antioxidant vitamins and retinol have been proposed to be protective against breast cancer on the basis of their ability to reduce oxidative DNA damage and their role in cell differentiation. Epidemiologic studies have not been convincing in supporting this hypothesis, but women with high exposure to free radicals and oxidative processes have not been specifically considered. We explored these issues in the Swedish Mammography Screening Cohort, a large population-based prospective cohort study in Sweden that comprised 59,036 women, 40-76 years of age, who were free of cancer at baseline and who had answered a validated 67-item food frequency questionnaire. During 508,267 person-years of follow-up, 1,271 cases of invasive breast cancer were diagnosed. Cox proportional hazards models were used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs). There was no overall association between intake of ascorbic acid, beta-carotene, retinol or vitamin E and breast cancer incidence. High intake of ascorbic acid was inversely related to breast cancer incidence among overweight women (HR=0.61; 95% CI 0.45-0.82, for highest quintile of intake among women with body mass index>25 kg/m(2)) and women with high consumption of linoleic acid (HR=0.72; 95% CI 0.52-1.02, for highest quintile of ascorbic acid intake and average consumption of more than 6 grams of linoleic acid per day). Among women with a body mass index of 25 or below, the hazard ratio for breast cancer incidence was 1.27 (95% CI 0.99-1.63), comparing the highest to the lowest quintile of ascorbic acid intake. Consumption of foods high in ascorbic acid may convey protection from breast cancer among women who are overweight and/or have a high intake of linoleic acid.
In order to prevent diet-induced cancer, many countries regulate the use of food additives (e.g. nitrites) and control the level of harmful substances, such as pesticide residues and mycotoxins in food. In most affluent countries therefore, these factors play a minor role in cancer causation. The dietary intake of agents preventing cancer, such as nutrients, dietary fibre and some natural components in plants is probably of much greater importance in cancer prevention. So far there are only general recommendations promoting increased consumption of food rich in these substances. Some international and national organizations have published dietary guidelines specifically intended to decrease the risk of cancer. In many respects, the recommendations given in these guidelines do not differ from those published during the last decades with the aim of preventing, for example, cardiovascular diseases. They all stress the need to decrease the intake of fat and sodium and to increase the consumption of foods rich in dietary fibre and nutrients such as vitamins A, C and E.