Risk factors for cancer of the oral cavity and oro-pharynx in Cuba.

In terms of worldwide levels, Cuba has an intermediate incidence of cancer of the oral cavity and oro-pharynx. We studied 200 cases of cancer of the oral cavity and pharynx, of whom 57 women (median age = 64) and 200 hospital controls, frequency matched with cases by age and sex, in relation to smoking and drinking history, intake of 25 foods or food groups, indicators of oral hygiene and sexual activity, and history of sexually transmitted diseases. Odds ratios (OR) and 95% confidence intervals (CI) were obtained from unconditional multiple logistic regressions and adjusted for age, sex, area of residence, education, and smoking and drinking habits. In the multivariate model, high educational level and white-collar occupation, but not white race, were associated with halving of oral cancer risk. Smoking > or =30 cigarettes per day showed an OR of 20.8 (95% CI: 8.9-48.3), similar to smoking > or =4 cigars daily (OR = 20.5). Drinking > or = 70 alcoholic drinks per week showed an OR of 5.7 (95% CI: 1.8-18.5). Hard liquors were by far the largest source of alcohol. Increased risk was associated with the highest tertile of intake for maize (OR = 1.9), meat (OR = 2.2) and ham and salami (OR = 2.0), whereas high fruit intake was associated with significantly decreased risk (OR = 0.4). Among indicators of dental care, number of missing teeth and poor general oral condition at oral inspection showed ORs of 2.7 and 2.6, respectively. Number of sexual partners, marriages or contacts with prostitutes, practice of oral sex and history of various sexually transmitted diseases, including genital warts, were not associated with oral cancer risk. 82% of oral cancer cases in Cuba were attributable to tobacco smoking, 19% to smoking cigars or pipe only. The fractions attributable to alcohol drinking (7%) and low fruit intake (11%) were more modest. Thus, decreases in cigarette and cigar smoking are at present the key to oral cancer prevention in Cuba.

Principal causes of poisoning in Quito, Ecuador: a retrospective epidemiology study.

At present there are no poison center or toxicology services available in Ecuador. In preparation to begin such a service it was decided to evaluate the occurrence and causes of poisoning in Quito (population 1.5 million). A retrospective chart review was performed for all of 1995 of all the patients admitted to the emergency departments of 3 main public hospitals of Quito for poisoning, excluding those who had ethanol and food poisoning. We analyzed sex, age, socio-economic status, origin and principal causes of poisoning; 850 cases were located. Predominant age groups seen were 15-30 y and 31-45 y. Poisoning with drugs was the major cause with 211 cases, followed by organophosphate and phosphorus poisoning. Principal drugs seen in poisoning were benzodiazepine, acetaminophen and aspirin. The occurrence of poisoning in Quito showed unique regional differences that will help prepare local health officials to establish intervention strategies for the reduction of morbidity and mortality from poisoning. Significant efforts in both public and professional education will need to be made to both reduce occurrence and better treat poisonings.

The A1 syndrome: a clinical entity?

We report two patients in whom suprasellar extension of pituitary tumours resulted in a motor deficit, in one case as the clinical presentation and in the other one as a consequence of trans-sphenoidal surgery. We emphasize the importance of the involvement of the initial segment of the anterior cerebral artery in pituitary tumours.

Cylindrical optical backplane.

A cylindrical optical backplane using Plexiglas stacked disks, light-emitting diodes, and p-i-n photodiodes is described. The main advantage of the design is its simplicity and lack of both precision optics and critical alignment requirements.

[Historic, cultural, legal, psychosocial and educational aspects of induced abortion]. / Aspectos históricos, culturales, legales, psicosociales y educativos del aborto inducido.

PIP: The history of abortion is a very long one. Every people and nation used different and widely varied methods during the centuries to get rid of unwanted pregnancies. Unfortunately, in most instances, the great majority of these methods was equivalent to zero effectiveness, or, too often, to suicide. Legal aspects of induced abortion have changed considerably with the passing of time and according to countries; these days 36% of the world countries admit abortion on request, 24% for specific reasons only, 16% for medical reasons only, and 8% still consider it an illegal practice. In Mexico abortion is legal only when pregnancy would imply death of the mother, when it is the result of rape of minors, or when it is done on women with very serious mental pathology. Obviously abortion is not the solution to unwanted pregnancies; an improvement in the socioeconomic condition and in the quality of life of many people would be a much better, and more difficult, approach to the solution. Psychosocial factors of abortion involve concepts which are difficult to define, such as those of the wanted or of the unwanted child, and can cause problems which are very difficult to handle. Health education, and sex education in particular, should not only teach the fundamentals of reproduction, but respect and consideration for the phenomenon of procreation, and a strong sense of personal and social responsibility toward family planning.^ieng