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  • 1
    Electronic Resource
    Electronic Resource
    The Association Between Tooth Loss and Coronary Heart Disease in Men and Women (2004)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of public health dentistry 64 (2004), S. 0 
    Details
    ISSN: 1752-7325
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: This paper evaluates the relation of tooth loss to incidence of coronary heart disease in two large cohort studies. Methods: Participants included 41,407 men and 58,974 women free of any cardiovascular diseases at baseline. We recorded 1,654 incident coronary heart disease events (562 fatal events) among men during 12 years of follow-up and 544 events (158 fatal events) among women during 6 years of follow-up. Results: After controlling for important cardiovascular risk factors, compared to men with 25–32 teeth at baseline, men with 0–10 teeth had a significantly higher risk of coronary heart disease (relative risk [RR]/1.36; 95 percent confidence interval [CI]/1.11, 1.67). The relative risk increased to 1.79 (95% CI/1.34, 2.40) when limited to fatal events. Women with 0–10 teeth were also at increased risk of coronary heart disease compared to women with 25–32 teeth (RR/1.64; 95% CI/1.31, 2.05). The association was similar for fatal events (RR/1.65; 95% CI=1.11, 2.46). The association between number of teeth and incidence of coronary heart disease was similar between men with and without a history of periodontal disease, and there was no significant association between tooth loss during follow-up and coronary heart disease. Conclusions: This study showed a significant association between number of teeth at baseline and risk of coronary heart disease and the mechanisms to explain this association should be further clarified. [J Public Health Dent 2004;64(4):209–15]
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1752-7325.2004.tb02755.x
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  • 2
    Electronic Resource
    Electronic Resource
    The Relationship Between Amalgam Restorations and Mercury Levels in Male Dentists and Nondental Health Professionals (2003)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of public health dentistry 63 (2003), S. 0 
    Details
    ISSN: 1752-7325
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objectives: The objectives of this study were: (1) to compare the mercury levels in general dentists with the mercury levels in other health professionals using toenail clippings as a biomarker, (2) to identify risk factors associated with high mercury levels, and (3) to compare practice characteristics of dentists with high and low mercury levels. Methods: A sample of 579 men was randomly selected from the 33,737 men participating in the Health Professionals Follow-up Study who had provided toenail samples in 1987. A questionnaire was sent to these male subjects in 1991 to obtain information on fish consumption, tooth-brushing frequency, number of teeth, number of amalgam restorations, general practice or specialty status, number of amalgam restorations placed and removed per week, mercury storage and handling procedures, and mercury spillage incidents. A measure of long-term mercury exposure was obtained from toenail samples using neutron activation analysis for the 410 respondents (71% response rate). The 90th percentile mercury level in toenails (0.88 ppm) was selected as the threshold for elevated toenail mercury level. Results: No relationship was found between the number of dental amalgams and toenail mercury levels among general dentists, dental specialists, and nondental health professionals. General dentists were found to have more than twice the level of mercury in toenails than nondental health professionals (mean level=0.94 vs 0.45) and 60 percent higher than dental specialists (mean=0.59). The combined use of disposable capsules and water storage of scrap amalgam appeared to reduce the risk of elevated mercury levels. Regardless of professional status, consumption of tuna and saltwater fish were the primary exposure factors that were positively associated with toenail mercury levels. Conclusions: As shown by the associations with dental profession and fish consumption, the mercury content of toenails is a stable biomarker of cumulative long-term mercury exposure. The lack of association between nail mercury levels and number of amalgam restorations suggests that avoidance of mercury amalgam restorative materials cannot be justified by the presence of mercury released from dental amalgams.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1752-7325.2003.tb03474.x
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  • 3
    Electronic Resource
    Electronic Resource
    Proportion of colon cancer risk that might be preventable in a cohort of middle-aged US men (2000)
    Springer
    Cancer causes & control 11 (2000), S. 579-588 
    Details
    ISSN: 1573-7225
    Keywords: colon adenoma ; colon cancer ; population attributable risk percent ; risk factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Diet and lifestyle likely play major roles in colon cancer incidence; however, the proportion of colon cancer risk that might be preventable is unknown. Thus, we estimated the proportion of colon cancer risk among men in the prospective Health Professionals Follow-up Study that might be attributable to a constellation of modifiable risk factors, and thus might be preventable. Methods: We included 47,927 men aged 40–75 years in 1986, among whom we confirmed 411 colon cancer cases from 1986 to 1996. Risk factors considered were obesity, physical inactivity, alcohol consumption, early adulthood cigarette smoking, red meat consumption, and low intake of folic acid from supplements. We calculated a risk score that was the sum across the six risk factors of the values of 1 (better exposure) to 5 (worse exposure) corresponding to the exposure category. We entered the risk score into a logistic regression model and estimated the population attributable risk percent (PAR%) using the method of Bruzzi et al. Results: After adjusting for age and family history of colorectal cancer and comparing the risk score for the combined six modifiable colon cancer risk factors at or above the approximate 20th, 10th, or 5th percentiles vs. below, the PAR% increased from 39% (95% confidence interval (CI) = 23–58%), to 48% (95% CI = 25–71%), to 55% (95% CI = 27–80%), respectively. Using a second method in which we used cut-points consistent with general-good health behaviors for each risk factor, comparing men with at least one risk factor to men without any risk factors (3.1% of the men), the PAR% was 71% (95% CI = 33–92%). Conclusion: The findings from this analysis suggest that, if all the members of this cohort of middle-aged US men had a modifiable exposure distribution comparable to the men with low risk scores, a large proportion of colon cancer risk might be avoidable. Additional study is required to determine whether making changes in these six risk factors now would reduce the risk of colorectal neoplasia, or whether the proportion of colon neoplasia that might be avoidable would be similar in populations with different characteristics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008999232442
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  • 4
    Electronic Resource
    Electronic Resource
    Diet, alcohol, and smoking and the occurrence of hyperplastic polyps of the colon and rectum (United States) (1995)
    Springer
    Cancer causes & control 6 (1995), S. 45-56 
    Details
    ISSN: 1573-7225
    Keywords: Cigarettes ; diet ; ethanol ; folate ; hyperplastic polyps ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Hyperplastic polyps of the colon reveal a geographic distribution similar to that of colorectal cancer and adenomatous polyps. However, unlike adenomas—known precursors of colorectal cancer—little is known about the etiology or clinical significance of the hyperplastic polyp. In this prospective study, we set out to determine the main dietary and other lifestyle factors in the United States that might be associated with this lesion. Hyperplastic polyps of the distal colon and rectum were diagnosed in 219 of 12,922 men of the Health Professionals Follow-up Study having had an endoscopic procedure between 1986 and 1992, and 175 of 15,339 women of the Nurses' Health Study who had undergone an endoscopy for a variety of reasons between 1980 and 1990. After adjusting for age, family history of colon cancer, history of previous endoscopy, and total energy intake using multiple logistic regression, those consuming 30 g or more of alcohol per day were at increased risk relative to nondrinkers among men (relative risk [RR]=1.69; 95 percent confidence interval [CI]=1.01–2.80) and women (RR=1.79, CI=1.02–3.15). Current smoking also was found to be associated strongly positively with hyperplastic polyps in men (RR=2.45, CI=1.59–3.75) and women (RR=1.96, CI=1.16–2.86). High intake of folate was associated inversely with risk in both men (RR=0.74, CI=0.49–1.11, between high and low intakes of folate) and women (RR=0.45, CI=0.28–0.74, between high and low intakes of folate). Among macronutrients, a suggestive increase in risk existed with intake of animal fat, although this was attenuated in the full multivariate model (RR[men]=1.48, CI=0.94–2.41, and RR [women]=1.22, CI=0.77–1.94) between high and low quantities of animal fat intake. These prospective data provide evidence of associations between low folate intake, alcohol consumption, and current cigarette smoking, and risk of hyperplastic polyps of the distal colon and rectum. These same factors also have been found to be related to adenoma and cancer of the colon. The hyperplastic polyp is an indicator of populations at high risk for colorectal carcinoma, and it also may serve as a marker for factors that influence neoplastic evolution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00051680
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  • 5
    Electronic Resource
    Electronic Resource
    Diabetes mellitus and risk of prostate cancer (United States) (1998)
    Springer
    Cancer causes & control 9 (1998), S. 3-9 
    Details
    ISSN: 1573-7225
    Keywords: Diabetes mellitus ; insulin ; prostatic neoplasms ; risk factors ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A lower risk of prostate cancer among diabetics has been suggested by several but not all studies. However, the studies have not always accounted for time since diagnosis of diabetes mellitus, or have not examined confounding factors such as diet and diagnostic bias. We thus examined this relationship in the Health Professionals Follow-Up Study from 1986 and 1994, in which 1,369 new cases of non-stage A1 prostate cancer were documented in 47,781 men. A prior history of a diagnosis of diabetes (mostly adult-onset) was associated with a reduced risk of prostate cancer (multivariate relative risk [RR] = 0.75; 95 percent confidence interval [CI] = 0.59-0.95) controlling for age, body mass index (wt/ht2) at age 21, and, in 1986, race, vasectomy, and intakes of total energy, total fat, calcium, fructose, and lycopene. After excluding the first year of follow-up after the diagnosis of diabetes, the RR was 0.63 (CI = 0.54-0.89). Prostate cancer was not reduced in the first five years after diagnosis (RR = 1.24, CI = 0.87-1.77), but was lower in the next five years (RR = 0.66, CI = 0.39-1.10) and lowest after 10 years (RR = 0.54, CI = 0.37-0.78); P-value for trend across time = 0.004. Similar associations were noted for advanced cases. Detection bias was unlikely to account for our findings. The basis of this relationship is unclear but may reflect hormonal changes related to diabetes, perhaps low testosterone levels.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008822917449
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