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In this work, we investigate the optical properties of hafnium dioxide nanocrystals, upon X-ray irradiation, looking for spectral evolution following thermal treatments in air up to 1000 °C that modify the crystal size as well as their point defect concentrations. Radio-luminescence measurements from 10 K up to room temperature reveal a rich and evolving picture of the optical features. A complete spectral analysis of the broad luminescence spectra reveals the presence of several emission components in the visible and UV regions. The lower energy components peaking at 2.1, 2.5, and 2.9 eV are characterized by a thermal quenching energy of 0.08 eV, while the corresponding value for the UV bands at 4.1 and 4.7 eV is close to 0.23 eV. We tentatively assign the components ranging from 2 to 3 eV to the presence of optically active defects of an intrinsic nature, together with the occurrence of titanium impurities; conversely, the bands at higher energies are likely to be of an excitonic nature. The comparison with previous photo-luminescence studies allows evidencing characteristic differences between the features of luminescence emissions caused by intra-centre excitation and those occurring under ionizing irradiation. Finally, scintillation measurements in the visible range reveal the existence of a fast decay in the nanosecond time scale for the smallest hafnia nanocrystals. This study offers a clear description of HfO2 luminescence characteristics upon excitation by X-rays and can lead to a better comprehension of the structure-property relationship at the nanoscale in metal oxides.
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BACKGROUND: The present paper focuses on socio-demographics, clinical variables, and the distance from the infection in predicting the long-term psycho-social consequences of COVID-19. METHODS: Patients were screened with a cross-sectional design at the Psychological Service of the University Hospital of Verona (Italy) at 3, 6, 12, and 18 months after their SARS-CoV-2 infection. The assessment was part of the Horizon 2020-funded ORCHESTRA Project and included the Hospital Anxiety and Depression Scale (HADS), the Short Form Health Survey 36 (SF-36), the Impact of Event Scale-Revised (IES-R), and ad-hoc questions measuring pre-post COVID-19 changes on psycho-social dimensions (sleep quality, nutrition, level of autonomy, work, social relationships, emotional wellbeing). RESULTS: Between June 2021 and June 2023, we evaluated 1317 patients (mean age 56.6 ± 14.8 years; 48% male): 35% at three months, 40% at 6, 20% at 12, and 5% at 18 months after the infection. Thirty-five percent were hospitalized due to COVID-19. Overall, 16% reported some form of clinically significant mental distress following the infection (HADS-TOT), with 13% and 6%, respectively, experiencing anxiety (HADS-Anxiety) and depressive symptoms (HADS-Depression). Four percent testified post-traumatic symptoms. The SF-36 scale revealed that 16% and 17% of subjects had physical or psychological deterioration in quality of life, respectively. The regression analyses showed that females experienced higher levels of anxiety and depression compared to males, along with worse mental and physical quality of life and pre-post infection changes in nearly all the investigated psycho-social dimensions. Younger people felt more anxiety and had a reduced mental quality of life than their older counterparts, who, in turn, had poorer scores in terms of autonomy and physical functioning. Hospitalized patients had lower levels of self-sufficiency, social relationships, and work than non-hospitalized people. The latter were more anxious and reported a lower physical quality of life. Finally, patients evaluated for the first time at 12- and 18 months showed a more significant impairment in mental and physical quality of life than those assessed at three months. CONCLUSIONS: Our data show that COVID-19 psychological sequelae tend to persist over time, still needing clinical attention and intervention planning, especially for females.
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The relationship of gestational trophoblastic disease (GTD) to parental age was evaluated in a case-control study of 132 women with hydatidiform mole (108) or choriocarcinoma (24) and 304 control subjects hospitalized for normal deliveries. Cases and controls were recruited in Lombardy (Northern Italy), and all were white and Italian. Compared to the risk of developing trophoblastic tumors in women 21-35 years old, the risk of developing trophoblastic tumors was elevated both in younger [less than or equal to 20 yr old, relative risk (RR) = 1.4, with 95% confidence interval (Cl) of 0.7-2.8] and in older subjects, RR being 1.2 (95% Cl 0.7-2.8) and 5.2 (95% Cl 2.2-12.3) for women 36-40 years old and over 40, respectively. The risk estimates for the last two categories were reduced to 0.7 (with 95% Cl of 0.3-1.9) and 2.5 (with 95% Cl of 0.7-8.9) when adjustment was made for paternal age by means of the Mantel-Haenszel procedure. Higher paternal age also was associated with GTD: Women whose husbands were 41-45 years old and over 45 had RR of 1.6 (with 95% Cl = 0.7-3.7) and 4.9 (with 95% Cl = 2.2-11.1), respectively, compared to women married to men less than 40 years old. These risk estimates were practically unchanged when adjustment was made for the woman's age. Examination of the effects of parental and maternal ages suggests that the highest risk estimate was observed when both parents were older. The findings of the present study were consistent with increased risk in the youngest maternal age group and confirm that older maternal age is associated with increased risk of GTD. Furthermore, showing a strong, independent effect of paternal age, they give epidemiologic support to the cytogenetic evidence of an androgenetic role in the origin of GTD.
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Coriocarcinoma/etiologia , Mola Hidatiforme/etiologia , Neoplasias Trofoblásticas/etiologia , Neoplasias Uterinas/etiologia , Adulto , Feminino , Humanos , Masculino , Idade Materna , Pessoa de Meia-Idade , Idade Paterna , Gravidez , Gravidez de Alto Risco , RiscoRESUMO
Dietary factors in the etiology of ovarian cancer were investigated with the use of data from a case-control study conducted in Northern Italy on 455 histologically confirmed epithelial carcinomas and 1,385 control subjects in the hospital for acute conditions unrelated to any of the known or potential risk factors for cancer of the ovary. Women with ovarian cancer reported significantly elevated frequency of consumption of meat [relative risk (RR) = 1.6 for greater than or equal to 7 vs. less than 4 portions/wk], ham (RR = 1.9 for greater than or equal to 4 vs. less than 2 portions/wk), and higher subjective scores of fat intake (RR = 2.1 for highest vs. lowest scores), particularly butter. In contrast, consumptions of fish, green vegetables, carrots, and wholemeal bread or pasta were less frequent in cases; the corresponding risk estimates for highest versus lowest frequencies ranged between 0.6 and 0.8. These results were not materially modified by adjustment for indicators of socioeconomic status, parity, and other identified determinants of ovarian cancer. No relation emerged between alcohol consumption and ovarian cancer risk. The present study provides interesting indications that help to explain the considerable variations in ovarian cancer rates in different populations and, if confirmed, could, in principle, have important public health implications. Due caution, however, is required in interpreting the present results because of the limitations of available information and of the uncertainties of other published material concerning diet and ovarian cancer.
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Carcinoma/etiologia , Comportamento Alimentar , Neoplasias Ovarianas/etiologia , Adulto , Idoso , Carcinoma/epidemiologia , Grupos Diagnósticos Relacionados , Dieta , Gorduras na Dieta/efeitos adversos , Feminino , Humanos , Itália , Produtos da Carne , Pessoa de Meia-Idade , Neoplasias Ovarianas/epidemiologia , Fatores de Risco , Fatores Socioeconômicos , Verduras , Vitamina ARESUMO
The relation between selected anthropometric indicators and the risk of endometrial cancer was evaluated using data from a case-control study conducted in Northern Italy on 562 cases and 1780 controls in hospital for acute, non-neoplastic or hormone-related disease. There was no appreciable association between height and endometrial cancer: compared with the lowest quintile, the multivariate relative risks (RR) were 0.9, 0.9, 0.7 and 0.8 for each subsequent quintile. Weight was directly associated with risk (RR = 2.7 for top vs. bottom quintile), and the positive association was even stronger when indices of body mass which make allowance for height were considered: the relative risks for extreme quintiles were 3.4 for W/H2 (Quetelet's index, weight and height), 3.8 for W/H1.5 and 3.5 for W0.33/H. Surface area, which was positively correlated both with height and weight, showed a weaker direct association (RR = 2.4 between extreme quintiles). The relations with measures of body weight were apparently stronger in postmenopause, but the point estimates for the upper quintile were also around 2 in premenopausal women. Although the major findings of this study are not new, they provide more detailed information that was hitherto available on the relation between various anthropometric indicators and endometrial cancer risk. In relation to height, with the sample size of this study it was possible to exclude, at the conventional 95% probability, relative risks above 1.0 for the fourth and above 1.1 for the fifth as compared with the lowest quintile. This provides indirect evidence against the hypothesis that nutritional status early in life is related to the subsequent development of endometrial cancer.
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Antropometria , Neoplasias Uterinas/etiologia , Adulto , Idoso , Estatura , Índice de Massa Corporal , Peso Corporal , Estudos de Casos e Controles , Feminino , Humanos , Menopausa , Pessoa de Meia-Idade , Fatores de RiscoRESUMO
The relationship between alcohol consumption and the risk of epithelial ovarian cancer was analysed using data from a case-control study of 801 histologically confirmed epithelial ovarian cancers and 2114 controls in hospital for acute, non-neoplastic, gynecological, or hormone-related conditions, admitted to a network of teaching and general hospitals in the greater Milan area, northern Italy, i.e. a region with comparatively frequent alcohol consumption by women. Compared to alcohol abstainers, the multivariate relative risks (RRs) were 1.0 [95% confidence interval (CI), 0.7 to 1.4] for less than one, 1.1. (95% CI 0.9 to 1.6) for one to two, 1.2 (95% CI 1.0 to 1.5) for two to three and 1.3 (95% CI 0.9 to 1.8) for three or more drinks per day. A significant direct trend in risk with dose emerged. This finding chiefly derived from an association between ovarian cancer risk and consumption of wine (which accounts for over 90% of alcohol intake in this female population). Although no significant interaction between the effect of alcohol consumption and various women's characteristics emerged, there was a hint that the adverse influence of alcohol consumption is more marked in middle-age and less educated women. Thus, the results of this study suggest that relatively elevated alcohol intake (of the order of 40 g per day or more) may cause a modest increase of epithelial ovarian cancer risk.
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Consumo de Bebidas Alcoólicas/efeitos adversos , Carcinoma/etiologia , Etanol/efeitos adversos , Neoplasias Ovarianas/etiologia , Adulto , Fatores Etários , Idoso , Cerveja , Estudos de Casos e Controles , Dieta , Relação Dose-Resposta a Droga , Escolaridade , Etanol/administração & dosagem , Feminino , Humanos , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco , VinhoRESUMO
The relationship between electrocoagulation diathermy and the risk of cervical neoplasia was evaluated in a case-control study of 145 women with cervical intraepithelial neoplasia compared with 145 age-matched outpatient control subjects, and 191 cases of invasive cervical cancer compared with 191 control subjects in the hospital for acute conditions unrelated to any of the identified or suspected risk factors for cervical cancer. History of electrocoagulation was associated with an apparently reduced risk of cervical intraepithelial neoplasia (relative risk = 0.50, with 95% confidence interval = 0.29-0.87), and of invasive cancer (relative risk = 0.42, 95% confidence interval = 0.22-0.82). However, this apparent protection could be largely explained in terms of a different frequency of previous Papanicolaou smears in patients and control subjects. When adjustment was made for that variable, the risk estimates of CIN and invasive cancer among women who had undergone electrocoagulation increased to 0.62 and 0.83 and became statistically nonsignificant. Further allowance for other identified potential confounding factors by means of multiple logistic regression raised these estimates to 0.73 and 0.94, respectively. Thus, these data provide evidence against the hypothesis that electrocoagulation may have an important and independent role in the prevention of cervical neoplasia.
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Carcinoma in Situ/epidemiologia , Eletrocoagulação , Displasia do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Teste de Papanicolaou , Risco , Doenças do Colo do Útero/cirurgia , Esfregaço VaginalRESUMO
Risk factors for complete and partial hydatidiform mole were analyzed in a case-control study conducted in the greater Milan area on 139 complete moles, 49 partial moles, and 410 obstetric control subjects. Patients tended to be more frequently nulliparous than controls, and the risk of complete mole and partial mole decreased with number of births, although the trend in risk was significant only for partial mole (chi 2(1) trend, P = .05). The risk for both histopathologic subgroups was greater in women reporting spontaneous miscarriages. Compared with women with no previous miscarriage, the estimated odds ratios (as estimators of relative risks) were 3.1 and 1.9, respectively, for complete mole and partial mole for two or more miscarriages. Infertility problems or difficulty in conception were associated with an odds ratio of 2.4 (95% confidence interval 1.3-4.3) and 3.2 (95% confidence interval 1.4-7.0), respectively, for complete mole and partial mole. No association emerged between mole and induced abortions and age at first pregnancy. A personal history of gestational trophoblastic disease increased the risk of both complete mole and partial mole: The odds ratios were 12.0 (95% confidence interval 3.0-38.9) and 18.1 (95% confidence interval 5.0-64.7), respectively. Similarly, a family history of gestational trophoblastic disease was more frequently reported in complete mole cases (five of 128) than in controls (one of 395) (odds ratio 16.0, 95% confidence interval 3.2-80.3). When the mating frequencies by patient/husband blood groups were considered, a nonsignificant increased risk was evident for women with group A married to men of group O in both histopathologic subgroups (odds ratio 1.5 compared with all other combinations).(ABSTRACT TRUNCATED AT 250 WORDS)
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Mola Hidatiforme/epidemiologia , Neoplasias Uterinas/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Mola Hidatiforme/patologia , Razão de Chances , Gravidez , Fatores de Risco , Fatores Socioeconômicos , Neoplasias Uterinas/patologiaRESUMO
Three hundred fifty-four evaluable cases of hydatidiform mole diagnosed from 1970 to 1979 in 10 regional hospitals in Lombardy are analyzed in the present report. Twenty-six (7.3%) of the patients developed persistent trophoblastic disease. Younger (less than 20 years) and older (40 years or more) age at diagnosis, a large-for-dates uterus, and ovarian enlargement were associated with an increased risk of developing persistent trophoblastic disease. Twenty-three (9%) cases of persistent trophoblastic disease were observed among 250 women not prophylactically treated, but only in 3 (3%) among 104 who received prophylactic chemotherapy. High-risk groups are defined and the role of prophylactic chemotherapy is discussed.
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Dilatação e Curetagem , Neoplasias Trofoblásticas/terapia , Neoplasias Uterinas/terapia , Adolescente , Adulto , Gonadotropina Coriônica/sangue , Dinoprosta , Feminino , Humanos , Relações Interinstitucionais , Itália , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Unidade Hospitalar de Ginecologia e Obstetrícia , Ovário/patologia , Gravidez , Prostaglandinas F/uso terapêutico , Neoplasias Trofoblásticas/epidemiologia , Neoplasias Trofoblásticas/prevenção & controle , Neoplasias Uterinas/epidemiologia , Neoplasias Uterinas/prevenção & controleRESUMO
STUDY OBJECTIVE: To examine the relationship between smoking and myocardial infarction in women. DESIGN: Case-control study over 5 years. SETTING: Cases were women admitted to 30 coronary care units in northern Italy. Controls were admitted to the same hospitals with other acute disorders. PARTICIPANTS: These were 262 young and middle aged women with acute myocardial infarction (median age 49 years, range 24-69) and 519 controls with other acute disorders unrelated to ischaemic heart disease (median age 47 years, range 22-69). MEASUREMENTS AND MAIN RESULTS: Stratification and the Mantel-Haenszel procedure, and unconditional multiple logistic regression were used to obtain relative risks according to levels of cigarette smoking. The regression equations included terms for age, education, coffee and alcohol consumption, diabetes, hypertension, hyperlipidaemia, body mass index and oral contraceptive use. Compared to life long non-smokers, relative risk was not significantly above unity for ex-smokers but among current smokers showed a significant trend to increasing risk with larger numbers of cigarettes smoked, with risk estimates of 2.3, 5.9 and 11.0 for less than 15, 15-24 and greater than or equal to 25 cigarettes per day respectively. Smoking related risks were consistently raised across strata of hyperlipidaemia, hypertension and increased alcohol and coffee intake. CONCLUSIONS: In terms of population attributable risk, about 48% of all myocardial infarctions in young and middle aged Italian women were attributable to cigarette smoking, which is therefore by far the most important preventable determinant of the disease.
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Infarto do Miocárdio/etiologia , Fumar/efeitos adversos , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Itália , Pessoa de Meia-Idade , Análise de Regressão , Fatores de RiscoRESUMO
The frequency of ectopic pregnancies in Lombardy (a region in Northern Italy with a population of about 9 million inhabitants) over the period 1979-1983 was estimated using the Regional Hospital Discharge Registration System, where information is collected on all discharges from public and private hospitals. The ratio of ectopic pregnancies rose from 4.43/1000 pregnancies in 1979 to 4.93/1000 pregnancies in 1982 and flattened off in 1983 (4.78/1000 pregnancies). The frequency of ectopic pregnancies increased with maternal age from 2.30/1000 pregnancies in teenagers to 6.01/1000 pregnancies in women 30-39 years old, but remained constant thereafter (5.84/1000 pregnancies in women aged 40 or older). These trends were consistent with available information on intrauterine device (IUD) sales over the same calendar period. On the basis of a random subsample of the same dataset, we evaluated by means of a case-control approach, the relative risk of ectopic pregnancy in relation to IUD use. Current IUD users had an estimated age-adjusted relative risk of ectopic pregnancy of 3.6 (95% confidence interval = 1.4-8.0) in comparison with an hospital-based control group of non-pregnant women. In etio-pathological terms, the interpretation of this finding is not obvious since it is possible that IUD users are simply less protected than pill, barrier or other traditional method users against ectopic pregnancy. Nonetheless, on a public health scale, the impact of IUD on the incidence of ectopic pregnancy should be evaluated in relative terms of comparison with other methods and their utilisation in different populations.
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Dispositivos Intrauterinos/efeitos adversos , Gravidez Ectópica/etiologia , Adulto , Métodos Epidemiológicos , Feminino , Humanos , Itália , Idade Materna , Gravidez , Gravidez Ectópica/epidemiologiaRESUMO
Information from published studies testing the effect of hormonal and mechanical interceptive methods in post-coital contraception was pooled with the aim of assessing the efficacy of various regimens. The pooled failure rates were 0.6% (19/3168 based on four studies) for high-dosage ethinylestradiol, 1.1% (11/975, based on two studies) for other high-dose estrogens, 1.8% (69/3802 based on 11 studies) for combined estro-progestin preparations, 2.0% (20/998 based on three studies) for danazol and 0.1% (1/879 based on nine studies) for intra-uterine devices (IUD). Although this overview has several limitations in terms of over-representation of optimistic results in the literature or absence of direct comparison between treatments in several studies, it suggests that IUD and high-dose ethinylestradiol are more efficacious forms of post-coital contraception than danazol or combined contraceptives.
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Anticoncepcionais Pós-Coito , Anticoncepcionais Pós-Coito/administração & dosagem , Esquema de Medicação , Feminino , Humanos , GravidezRESUMO
In order to identify subgroups of women at elevated risk of induced abortion, personal characteristics and habits, selected medical histories and contraceptive practices of 873 women undergoing legal abortion in various areas of Northern Italy were compared with those of 504 control subjects identified in family planning clinics of the same hospitals or area health authorities. When age was allowed for, the risk of induced abortion was not strongly influenced by marital status, education or other indicators of social class. However, women who were employed, independently from the type of occupation, showed markedly lower abortion risks than housewives. Among various indicators of sexual habits investigated, the strongest determinant of legal abortion was the frequency of sexual intercourses over the previous six months, women with less frequent intercourses showing a markedly elevated risk estimate (RR = 2.82). Induced abortion was less frequent among ex-smokers and more frequent in heavy smokers, but was not appreciably influenced by several other indicators of lifestyle habits and history of gynaecological or psychiatric complaints. The risk of abortion was not influenced by the number of livebirths, but was lower for women with later age at first birth. Less than 5% of case and control subjects reported more than two previous induced abortions, thus indicating that abortion is more of an "accidental" event rather than a widespread contraceptive practice. However, over three-quarters of abortions occurred in women reporting no contraception at all or coitus interruptus, thus underlining the scope for family planning education in this population.
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Aborto Legal , Adolescente , Adulto , Fatores Etários , Feminino , Humanos , Itália , Masculino , Casamento , Gravidez , Risco , População Rural , Sexo , Fatores Socioeconômicos , População UrbanaRESUMO
Number of certified deaths, age-specific and age-standardised rates and percentages of all cancer deaths from 30 cancers or groups of cancers (plus total cancer mortality) for each five-year calendar period between 1955 and 1984 in Italy are presented in tabular form. From these data, three graphs are derived, including trends in age-standardised rates, age-specific rates centered on birth cohorts and maps plotted in different shades of grey to represent the surfaces defined by the matrix of various age-specific rates. These analyses quantified the rises in overall cancer mortality in males (from 137 to 192/100,000 world standard), chiefly due to increases in lung and other tobacco-related neoplasms. Overall cancer mortality was stable in females (around 100/100,000). Appreciable cohort effects were evident for tobacco related neoplasms, but also for other major cancer sites, such as intestines or breast, whose rates, after earlier rises, are now stable in earlier middle age. Since the early 1970's, cancer mortality rates have been declining in all age groups below 40 in males and below 55 in females. These declines reflect improvements in therapy for leukemias, lymphomas and germ cell tumors, and general improvements in food availability and storage, hygiene and early diagnosis, which have led to the declines in stomach and cervical cancer. Although moderate in absolute terms and smaller than in other western countries where tobacco-related neoplasms have also been falling in more recent cohorts, these declines are encouraging for the indication they provide on the most likely patterns over the next decades in the same and subsequent generations.
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Neoplasias/mortalidade , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Itália , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologiaRESUMO
STUDY OBJECTIVE: To examine the relation between selected foods and acute myocardial infarction in women. DESIGN: Case-control study conducted over five years. SETTING: 30 Hospitals with coronary care units in northern Italy. SUBJECTS: 287 Women who had had an acute myocardial infarction (median age 49, range 22-69 years) and 649 controls with acute disorders unrelated to ischaemic heart disease (median age 50, range 21-69 years) admitted to hospital during 1983-9. MAIN OUTCOME MEASURES: Frequency of consumption of various foods and odds ratios of risks associated with these foods. RESULTS: The risk of acute myocardial infarction was directly associated with frequency of consumption of meat (odds ratio 1.5 for upper v lower thirds of consumption), ham and salami (1.4), butter (2.3), total fat added to food (1.6), and coffee (2.8). Significant inverse relations were observed for fish (0.6), carrots (0.4), green vegetables (0.6), and fresh fruit (0.4). The risk was below one for moderate alcohol consumption (0.7) and above one for heavier intake (1.2). Allowance for major non-dietary covariates, including years of education, smoking, hyperlipidaemia, diabetes, hypertension, and body mass index, did not appreciably alter the estimates of risk for most of the foods; for coffee, however, the odds ratio fell to 1.8 on account of its high correlation with smoking. CONCLUSIONS: The frequency of consumption of a few simple foods may provide useful indicators of the risk of myocardial infarction. Furthermore, specific foods such as fish, alcohol, or vegetables and fruits may have an independent protective role in the risk of cardiovascular diseases.