Frequency and distribution of cyanogenic glycosides in Eucalyptus L'Hérit.

In this study approximately 420 of the described species of Eucalyptus were examined for cyanogenesis. Our work has identified an additional 18 cyanogenic species, 12 from living tissues and a further six from herbarium samples. This brings the total of known cyanogenic species to 23, representing approximately 4% of the genus. The taxonomic distribution of the species within the genus is restricted to the subgenus Symphyomyrtus, with only two exceptions. Within Symphyomyrtus, the species are in three closely related sections. The cyanogenic glycoside was found to be predominantly prunasin (1) in the 11 species where this was examined. We conclude that cyanogenesis is plesiomorphic in Symphyomyrtus (i.e. a common basal trait) but has probably arisen independently in the other two subgenera, consistent with recent phylogenetic treatments of the genus. The results of this study have important implications for the selection of trees for plantations to support wildlife, and to preserve genetic diversity.

Prevalence of foot and ankle conditions in a multiethnic community sample of older adults.

The prevalence of foot and ankle disorders was determined in a community-based, multiethnic (non-Hispanic White, African American, and Puerto Rican) random sample of 784 community-dwelling adults aged 65 or more years in 2001-2002 in Springfield, Massachusetts. Overall, the five most common conditions were toenail disorders (74.9%), lesser toe deformities (60.0%), corns and calluses (58.2%), bunions (37.1%), and signs of fungal infection, cracks/fissures, or maceration between toes (36.3%); 30.9% had some tenderness to palpation of the foot or ankle, and 14.9% had ankle joint pain on most days in the past 4 weeks. Toenail conditions, fungal symptoms, and ulcers or lacerations were more common in men, while bunions and corns and calluses were more common in women (p < 0.001). Significant racial/ethnic differences, independent of education or gender, were found for the prevalence of most toe deformities and flat feet, as well as for corns and calluses, fungal signs, edema, ankle joint pain, tenderness to palpation, and sensory loss. Foot and ankle disorders are common in these older adults. Examination of their prevalence in different segments of the community may inform future studies to determine etiology and means of prevention.

Seven-year tracking of dietary factors in young adults: the CARDIA study.

OBJECTIVES: This report determines the extent to which young adults in the highest and lowest intake quintiles of 13 nutrients remain in the same or adjacent quintiles (i.e., "tracked") relative to each other, over 7 years. METHODS: Data from baseline and year 7 of the CARDIA study were divided into race/gender-specific quintiles for each nutrient and cross-tabulated. RESULTS: For most nutrients, over 60% of those in the lowest absolute intake quintile at year 0 remained in the lowest or second-lowest quintile at year 7. A similar pattern was seen with highest absolute intake quintiles at years 0 and 7. Tracking was attenuated when nutrient density, rather than absolute intake, was examined. CONCLUSIONS: Ingrained dietary habits may cause high- or low-intake groups to retain relative ranking, even in the face of secular, age-, or lifestyle-related trends in dietary intake.

Frequency of fractures in women with systemic lupus erythematosus: comparison with United States population data.

OBJECTIVE: To describe the frequency of self-reported fractures in a large population-based cohort of women with lupus, to compare the frequency of self-reported fractures between lupus patients and women of similar age in the general population by use of data from the 1994 National Health Interview Survey (NHIS), and to describe the associated risk factors for fracture in women with lupus. This study is a secondary analysis of data collected to assess cardiovascular risk in women with lupus. METHODS: Fractures and associated risk factors were ascertained by self report in this retrospective cohort study of 702 living women with lupus who were followed up for 5,951 person-years. Self-reported fractures were verified in a subset of patients. A Weibull regression model was used to assess risk factors associated with time from lupus diagnosis to fracture in the univariate and multivariate analyses. Age-specific standard morbidity ratios (SMRs) were calculated to determine whether fracture occurrence was greater than expected in women with lupus. RESULTS: Eighty-six (12.3%) of 702 women reported at least 1 fracture following the diagnosis of lupus. The sites of the first fracture were the leg (n = 32), foot (n = 16), arm (n = 15), spine (n = 9), rib (n = 7), hip (n = 2), pelvis (n = 2), hand (n = 1), shoulder (n = 1), and finger (n = 1). Fracture risk was increased in the lupus cohort compared with women of similar age from the United States population, using weighted data from the 1994 NHIS (SMR 4.7; 95% confidence interval 3.8, 5.8). Variables in the univariate analysis that were significantly associated (P < 0.05) with time from lupus diagnosis to fracture were older age at lupus diagnosis, longer disease duration, longer duration of corticosteroid use, less use of oral contraceptives, and menopause status. In the multivariate analysis, independent determinants of time from lupus diagnosis to fracture were older age at lupus diagnosis and longer duration of corticosteroid use. CONCLUSION: Fractures occurred in 12.3% of lupus patients who were followed up for 5,951 person-years. There was nearly a 5-fold increase in fracture occurrence in the women with lupus compared with women from the US population. Older age at lupus diagnosis and longer use of corticosteroids were associated with time from lupus diagnosis to fracture. With increased life expectancy of lupus patients, fracture occurrence is a major threat to the health of these women. Prevention strategies must be directed toward minimizing the occurrence of fractures in these patients.

Increased risk of fracture in patients receiving solid organ transplants.

The success of organ transplantation is related to advances in immunosuppressive therapy. These medications are associated with medical complications including bone damage. The objective of this study was to estimate and compare age, gender-specific fracture incidence between transplant recipients, and a large sample representative of the civilian noninstitutionalized United States population using the 1994 National Health Interview Survey (NHIS). This was a cohort study set in tertiary care centers. Five hundred and thirty-nine individuals who received abdominal organ and 61 heart transplants surviving at least 30 days at our institution from 1986 to 1996 were included in the study. Incident fractures were ascertained by mail, in-person interview, telephone survey, or medical record review. All fractures were verified. Organ-, age-, and gender-specific fracture numbers and rates and person-years of observation, were calculated for the transplant patients. Weighted age- and gender-specific fracture rates from the 1994 NHIS were applied to the number of person-years of observation for each organ-specific age and gender category of transplant patients to generate an expected number of fractures. The ratio of observed to expected number of fractures was used to compare fracture experience of transplant patients to that of the national sample from the 1994 NHIS. Fifty-six of 600 (9.3%) patients had at least one fracture following 1221 person-years of observation. The sites of initial symptomatic fracture were as follows: foot (n = 22), arm (n = 8), leg (n = 7), ribs (n = 6), hip (n = 4), spine (n = 3), fingers (n = 3), pelvis (n = 2), and wrist (n = 1). Fracture incidence was 13 times higher than expected in male heart recipients age 45-64 years; nearly 5 times higher in male kidney recipients age 25-44 and age 45-64 years; and 18 times and 34 times higher in female kidney recipients age 25-44 years and 45-64 years compared with NHIS data. We have shown an increased incidence of fractures and estimated the magnitude of this problem in patients undergoing solid organ transplantation. Our work defines the need for a long-term prospective study of fracture risk in these patients.

The relationship of visual and hearing impairments to disability: an analysis using the longitudinal study of aging.

BACKGROUND: Little is known about the relationships of visual impairment and hearing impairments to physical disability. The purpose of this work is to determine if persons 70 years of age and over with these impairments are at risk for increased disability in basic physical activities of daily living (ADLs) compared to persons without these impairments. METHODS: We used as our data source the baseline (1984) and the 1988 reinterview from the Longitudinal Study of Aging, a nationally representative survey of noninstitutionalized persons 70 years of age and older. To determine the relationships of visual impairment and hearing impairment to future four-year disability, we used multiple variable modeling, controlling for demographic variables, selected chronic conditions, and baseline disability. RESULTS: Persons with visual impairment were 1.37 (95% CI:1.20-1.57) times more likely to have increased disability in ADLs than those without visual impairment. Hearing impairment was not independently related to increased ADL disability. CONCLUSIONS: Visual impairment by itself is an independent risk factor for future ADL disability. In light of the enlarging older population, maneuvers to ameliorate visual impairment may help to minimize the increase in numbers of disabled persons.

Do falls predict institutionalization in older persons? An analysis of data from the Longitudinal Study of Aging.

Data from the Longitudinal Study of Aging (LSOA) were analyzed to estimate the subsequent risk of institutionalization associated with a report of one or more falls, and to determine if the association is affected by controlling for demographic traits, chronic conditions, and disabilities present at baseline. Risk was estimated at two time points, 2 years and 4 years after baseline interview. A report of multiple falls at baseline was associated with an increased risk of institutionalization at both 2 years (odds ratio [OR] 3.1; 1.9-5.3) and 4 years (OR 2.6; 1.6-4.4) of follow-up. The risk was decreased but remained significant in a model controlling for age, sex, marital status, and selected chronic conditions associated with both report of falls and institutionalization. However, multiple falls were not significantly associated with institutionalization when measures of disability (number of difficulties with activities of daily living) were added to the model. These analyses suggest that multiple falls should be regarded as an important sentinel event to alert caregivers to the presence of underlying disease and disability that may require intervention.

Mortality, disability, and falls in older persons: the role of underlying disease and disability.

BACKGROUND: Falls are prevalent in older persons and can have serious consequences. METHODS: Data from the Longitudinal Study on Aging were analyzed to study the relationship between falls and both mortality and functional status in 4270 respondents age 70 and over. The effects of demographic traits, chronic conditions, and disability present at baseline were controlled for by means of multivariable analyses. RESULTS: Risk of death within 2 years was greater for both single fallers (crude odds ratio [OR], 1.5; 95% confidence interval [CI], 1.1-2.0) and multiple fallers (crude OR, 2.2; 95% CI, 1.7-2.8). This excess risk was dissipated when selected covariates were added to the model. No crude or adjusted association was evident between single falls and functional impairment; however, multiple falls were an independent risk factor (adjusted OR, 1.6; 95% CI, 1.2-2.0). CONCLUSIONS: Multiple falls in older persons increase risk of functional impairment and may indicate underlying conditions that increase risk of death.

Heritability estimates of pregnancy rate in beef cows under natural mating.

Observations of 3,029 matings over 17 yr on an Ozark upland range were used to estimate heritability of pregnancy rate in Angus, Hereford and Polled Hereford cows. Pregnancy rate, the percentage of cows exposed that produced a live calf in the spring, was transformed using the empirical logit transformation and then analyzed for each breed separately by weighted least squares using a mixed model procedure. A numerator relationship matrix for sires of cows was incorporated into the sire model to account for relationships among sires. Variation among years significantly affected pregnancy rate in all three breeds. Age of dam significantly affected pregnancy rate in the Angus and Hereford groups. Paternal half-sib estimates of heritability from the observed binary data (h2b) for pregnancy rate were calculated on first-calf heifers and mature cows for each breed. Respective h2b estimates for heifers and mature cows were .17 and .09 in the Angus group, .04 and .01 in the Hereford group and .05 and .05 in the Polled Hereford group. The heritability estimates when binary records were transformed to the probit scale (h2) were .04 +/- .003 and .02 +/- .001 for Angus, .01 +/- .002 and 0 for Hereford and .01 +/- .001 and .02 +/- .001 for Polled Hereford for heifers and mature cows, respectively. Heritability estimates in this study are in agreement with the literature, indicating little opportunity for improvement in pregnancy rate by selection within a breed.

Cervical cancer occurrence in Memphis and Shelby County, Tennessee, during 25 years of its cervical cytology screening program.

This review of the cytologic history of 430 women with histologically proved invasive cancer of the uterine cervix indicates that several significant subgroups can be defined. One major subgroup consists of 142 patients or 33% of the total group in whom invasive cancer developed within 1 to 5 years, with an average of 2.6 years, after one or more negative cytologic findings. This appears to be a significant proportion of the occurrence of invasive cervical cancer and warrants consideration in the recommendation of screening intervals. The second major subgroup, consisting of 88 patients (20.5%), had a delay in diagnosis averaging 9.9 years after the first abnormal cytologic finding. In some of these patients either the cytologic examination results reverted to negative for a period or the biopsy material did not confirm the cytologic abnormalities. The disease progressed to invasion. These findings appear to bear out the importance of close follow-up of patients with any abnormal cytologic finding in the intraepithelial neoplasia category even though intermittent cytologic studies may appear negative.

Multiple glomus tumors associated with multiple neoplasias.

We report the case of a 60-year-old man who presented with a lentigo maligna melanoma, which led to the discovery of a malignant endobronchial tumor and who had noticed the appearance of disseminated multiple glomus tumors about 10 years before. The late onset of this form of benign vascular tumor raises the question whether multiple glomus tumors may have been, in this case, a cutaneous marker of the development of underlying malignancy.

The relationship of cervical cytology to the incidence of invasive cervical cancer and mortality in Alameda County, California, 1960 to 1974.

Cervical cytology as an examination procedure is nearly ideal for discovering unsuspected cervical epithelial malignant changes. A large proportion of women is now being examined periodically with this procedure, and the question now is what effect has this had on the occurrence of invasive cervical cancer and deaths from this disease. Data are available on invasive cervical cancer and its mortality in Alameda County, California, for the 15 years, 1960-1974. Population survey data are available on the experience of women in the County with cervical cytology in 1962 and again in 1973-1974. All cases diagnosed in 1971-1975 were reviewed for a history of cytologic examinations in the 5 years prior to diagnosis. There has been a reduction of over 40% in the occurrence of invasive cervical cancer and mortality among white women in the 10 years 1960-1964 versus 1970-1974. There has been a lesser reduction in both among black women. Twenty-nine percent of women who developed invasive cervical cancer during 1970-1974 had a history of recent negative cytology. This finding indicates that not all invasive cervical cancers have a prolonged in situ stage.

Further characterization of herpes virus persistence.

Infection of cell cultures with herpes simples virus type 1 (HSV-1) under standard culture conditions yielded persistently infected cells capable of continued growth in the presence of virus and of forming colonies in agarose. The ability of an infected culture to yield cells able to survive HSV-1 infection was directly related to the presence of S phase cells (cells actively engaged in DNA synthesis) at the time of infection. Only when very high multiplicities of infecting virus (greater than 10) were used did cultures fail to yield persistently infected cells capable of colonial growth in agarose. Cell clones derived from colonies grown in agarose established cell cultures which possessed all the characteristics of HSV-1 persistently infected cultures. When cultures were cloned a second time in agarose, as a rare event, cell cultures which did not immediately liberate infectious virus could be isolated. These cell cultures, however, possessed an increased resistance to superinfection by HSV-1. On continued cultivation they reverted to persistence as exhibited by the sudden onset of virus cytopathic effects and release of infectious virus.