Differences in male breast cancer stage, tumor size at diagnosis, and survival rate between metropolitan and nonmetropolitan regions.

Although the incidence for breast cancer in men is lower than for women, male breast cancer (MBC) patients are diagnosed at a later stage and have a higher mortality rate than women. This study examined male cases reported from 1988 through 2006 in the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute for differences in cancer stage, tumor size at diagnosis, and survival rate between metropolitan and nonmetropolitan regions. Pearson's chi-square was used to evaluate differences in stage and tumor size at diagnosis. Cox proportional hazards regression was used to assess survival differences after adjusting for confounders (race, marital status, median family income, age, and education). Regional differences in tumor grade size and stage at diagnosis were not statistically significant; however, survival differences were observed between metropolitan and nonmetropolitan regions. An interaction between nonmetropolitan area and regional stage MBC was a significant predictor of poorer survival. Raising awareness of MBC in nonmetropolitan areas could save the lives of many men and action should be taken to improve health care access, treatment, and thus prognosis in this population.

Immigration, income, drinking and obesity in African American adults.

The objective of this study was to investigate the relationship between immigration status, income, drinking and overweight and obesity in African American adults residing in the United States using an internet web based survey. Data on 303 adult African American immigrants and non-immigrants was collected using a self-administered web based survey. Respondents were recruited using a snowball sampling technique to obtain a convenience sample. Multiple logistic regression analysis were used to test the independent effects of the immigration status while controlling for confounding effects of demographic, social and behavioral variables. The results of the study showed no significant difference between obesity and immigration status in black adults residing in the US (adjusted odds ration = 1.1095, P = 0.7489). Significance at the P < 0.05 level was demonstrated for obesity and two independent variables: age (OR = 1.0332, P = 0.0298) and days per month consumed more than 5 alcoholic beverages (OR = 1.7735, P = 0.0001). Adult African American immigrants in this study sample were not at risk of being obese due to their immigration status. However, age and days in a month in which more than 5 alcoholic beverages are consumed were significant risk factors for obesity. Primary care providers should be alert for obesity and alcohol consumption in this population.

Human Salmonella infections linked to contaminated dry dog and cat food, 2006-2008.

OBJECTIVE: Human Salmonella infections associated with dry pet food have not been previously reported. We investigated such an outbreak of Salmonella Schwarzengrund and primarily affecting young children. PATIENTS AND METHODS: Two multistate case-control studies were conducted to determine the source and mode of infections among case-patients with the outbreak strain. Study 1 evaluated household exposures to animals and pet foods, and study 2 examined risk factors for transmission among infant case-patients. Environmental investigations were conducted. RESULTS: Seventy-nine case-patients in 21 states were identified; 48% were children aged 2 years or younger. Case-households were significantly more likely than control households to report dog contact (matched odds ratio [mOR]: 3.6) and to have recently purchased manufacturer X brands of dry pet food (mOR: 6.9). Illness among infant case-patients was significantly associated with feeding pets in the kitchen (OR: 4.4). The outbreak strain was isolated from opened bags of dry dog food produced at plant X, fecal specimens from dogs that ate manufacturer X dry dog food, and an environmental sample and unopened bags of dog and cat foods from plant X. More than 23 000 tons of pet foods were recalled. After additional outbreak-linked illnesses were identified during 2008, the company recalled 105 brands of dry pet food and permanently closed plant X. CONCLUSIONS: Dry dog and cat foods manufactured at plant X were linked to human illness for a 3-year period. This outbreak highlights the importance of proper handling and storage of pet foods in the home to prevent human illness, especially among young children.