The prevalence and 3-year incidence of dementia in older Black and White community residents.

OBJECTIVE: To determine the prevalence and 3-year incidence of dementia in Blacks and Whites age 65 and older in a five-county Piedmont area of North Carolina. DESIGN: Stratified random sample of members of the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE) (baseline n = 4,136; 55% Black; weighted n = 28,000). Prevalence study members were differentially selected on the basis of score on the Short Portable Mental Status Questionnaire at the second in-person Duke EPESE wave. Incidence study members included all persons with obvious cognitive decline over a 3-year period, and a 10% sample of the remainder. MEASUREMENTS: Self- and informant report on health history, functional status, and memory. Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychology Battery administered to all subjects, and CERAD Clinical Battery to those with impaired memory. Clinical consensus to determine presence and type of dementia. RESULTS: Prevalence of dementia for persons > or =68 years old was 0.070 (95% confidence interval = 0.021-0.119) for Blacks and 0.072 (0.022-0.122) for Whites. Rates for Black men (0.078, 0.001-0.155) exceeded those for Black women (0.066, 0.003-0.129), but gender rates for Whites were reversed (men: 0.044, 0.000-0.103), (women: 0.087, 0.015-0.160). Neither race nor gender differences were significant. Prevalence of dementia increased through age 84 and tapered off thereafter. Three-year incidence of dementia was 0.058 (0.026-0.090) for Blacks and 0.062 (0.027-0.097) for Whites. Neither race nor gender differences were significant. Incidence increased through age 84, but moderated thereafter for all but Black men. The proportional representation of different types of dementia varied little by race. CONCLUSION: Prevalence, 3-year incidence, and types of dementia are comparable in Black and White elderly in the Piedmont area of North Carolina.

Developing a summary measure of medical status.

Health status surveys and assessments typically obtain detailed information on specific physical health conditions. While such specific details are important, it is frequently also valuable to have a summarized evaluation of medical conditions which can be used to compare subjects, or for statistical analyses. Using data from the Duke Established Populations for Epidemiologic Studies of the Elderly survey, we indicate how to obtain a weighted sum of chronic medical conditions. Like the sum of the same conditions, it explains variance in selected measures of health service use and health status, in some instances making a contribution beyond that of the summed measure. It is a significantly better predictor of mortality within six years.

Force degradation in elastomeric chains.

Elastomeric chains are a frequent choice for delivering forces required to close spaces orthodontically. Unfortunately, these forces degrade over time. Open and closed chains from six orthodontic suppliers were evaluated over time. For both types and for all suppliers, the greatest loss of force occurred within the first hour. During the next 2 to 4 days, forces delivered continued to fall but at a slower rate. Beyond that time, in general, forces delivered remain nearly constant but at a level lower than originally available. The amount of the force delivered at 28 days ranged from 85% to 30% of that available at the time of placement. At 28 days, gray chains from all suppliers delivered forces greater than 100 g.

Steaming oysters does not prevent Norwalk-like gastroenteritis.

OBJECTIVES: To determine whether steaming oysters prevents gastroenteritis caused by small round structured (Norwalk-like) viruses and to identify risk factors for illness. METHODS: The authors interviewed all 48 people who ate oysters at two church suppers that were followed by outbreaks of gastroenteritis from a Norwalk-like virus. Data were collected on demographics, clinical illness, number of oysters eaten, and the extent to which they were cooked. RESULTS: Among the 48 persons, the attack rate was 56%. The risk of illness increased with the number of oysters eaten (chi-square for trend = 5.7, P = 0.02). There was no decrease in attack rates among persons who ate oysters that were better done (chi-square for trend = 1.1, P = 0.29). CONCLUSIONS: In these outbreaks, the risk of illness increased with the number of oysters eaten. Steaming oysters did not appear to prevent illness, suggesting that steaming may not be adequate to inactivate small round structured viruses. Public health messages that have emphasized the role of raw shellfish in the transmission of enteric viruses should be altered to increase the public's awareness that eating steamed oysters may also pose health risks.

Sudden infant death syndrome and local meteorologic temperature in North Carolina.

The association between meteorologic temperature and sudden infant death syndrome was investigated in the 1982-1983 North Carolina birth cohort. Maximum daily temperatures recorded at weather stations in the subject's county of residence for each day of the first year of life were entered into hazards models as time-dependent covariates. Risk ratios for a maximum temperature of < or = 53 degrees F (12 degrees C) 5 days before the event compared with a maximum temperature of > 53 degrees F were 2.3 (95% confidence interval 1.6-3.3) for blacks and 1.5(95% confidence interval 1.0-2.1) for whites. Similar results were found for minimum daily temperature. The analysis controlled for season of birth, sex, maternal age, maternal education, parity, and birth weight.

Home pesticide use and childhood cancer: a case-control study.

The association between childhood cancer and home pesticide use was examined in a case-control study of children under 15 years of age. Parents of 252 children diagnosed with cancer in the Denver area between 1976 and 1983 and of 222 control subjects were interviewed regarding use of home pest extermination, yard treatment, and pest strips. The strongest associations were found for yard treatments and soft tissue sarcomas (odds ratios [ORs] around 4.0) and for use of pest strips and leukemias (ORs between 1.7 and 3.0). These results suggest that use of home pesticides may be associated with some types of childhood cancer.

Segmented approach to simultaneous intrusion and space closure: biomechanics of the three-piece base arch appliance.

Deep overbite correction and space closure in patients with flared incisors are mechanically difficult to achieve with conventional orthodontic treatment. The purpose of this article is to present an appliance design that allows simultaneous intrusion and retraction of anterior teeth as well as correction of their axial inclinations. A three-piece base arch was used to achieve simultaneous intrusion and space closure. Various clinical situations are discussed and analyzed from a biomechanical standpoint. Sequences of treatment, appliance design, and management of side effects are described in detail. The segmented approach to simultaneous intrusion and space closure is useful for achieving precise control of tooth movements in the anteroposterior and vertical dimensions.

Age and season of birth in sudden infant death syndrome in North Carolina, 1982-1987: no interaction.

Sudden infant death syndrome (SIDS) is a major cause of death in the postneonatal period. SIDS peaks in the winter and at age 3 months. The hypothesis that season and age interact to determine SIDS survival was tested in race-specific hazards models that included an interaction term for season of birth and survival time. The study population was the 1982-1984 and 1985-1987 North Carolina birth cohorts. The interaction term had null effect in all models, indicating that season and age are independent determinants of SIDS survival. These results may be confounded by exposure to cigarette smoke, for which no data were available.