ABSTRACT
PURPOSE: To investigate the relationships between dietary macronutrient intake at baseline and the five-year incidence of the three main types of cataract in older people. DESIGN: Population-based cohort study. SETTINGS: An urban community near Sydney, Australia. STUDY POPULATION: The Blue Mountains Eye Study (BMES) examined 3,654 predominantly Caucasian participants aged 49+ years during 1992 to 1994, and then 2,335 survivors (71.5%) after five years. Of these 2,335 subjects, 1988 (85%) completed a Willett-derived food frequency questionnaire (FFQ) at baseline. OBSERVATION PROCEDURES: A 145-item FFQ was used to assess nutrient intakes and lens photography was used to assess the presence of cataract at both time points. MAIN OUTCOME MEASURES: Incidence of cortical, nuclear, and posterior subcapsular (PSC) cataract was assessed via lens photographic grading following the Wisconsin cataract grading method. RESULTS: After adjusting for multiple known cataract risk factors, higher dietary intakes of omega-3 polyunsaturated fatty acids (n-3 PUFA) were associated with a reduced incidence of nuclear cataract. The odds ratio (OR) for subjects in the highest quintile of intake compared to those in the lowest quintile was 0.58 (95% confidence interval [CI] 0.35 to 0.97), P(trend) = .027. Similarly, for PSC cataract, higher dietary intakes of protein were protective (OR 0.28; 95% CI 0.10 to 0.76), P(trend) = .015. Dietary macronutrient intake was not associated with incident cortical cataract. CONCLUSIONS: Higher dietary intakes of n-3 PUFA may decrease the five-year risk of nuclear cataract, whereas higher dietary intakes of protein may decrease risk for PSC cataract.
Subject(s)
Cataract/epidemiology , Diet , Nutritional Physiological Phenomena , Nutritional Status , Aged , Aged, 80 and over , Cataract/prevention & control , Cohort Studies , Diet Records , Eating , Fatty Acids, Omega-3/administration & dosage , Female , Humans , Incidence , Male , Middle Aged , New South Wales/epidemiology , Nutrition Assessment , Risk Factors , Urban Population/statistics & numerical dataABSTRACT
Viral encephalitis is associated with significant morbidity and mortality, particularly when appropriate management is omitted as a result of delayed diagnosis. A case of herpes simplex virus type 1 (HSV-1) encephalitis is presented, demonstrating that the presentation of confusion, speech difficulties and fever with non-specific early brain CT appearances can easily be misdiagnosed as pneumonia with stroke. This case highlights the need for increased awareness of HSV-1 encephalitis among emergency physicians and radiologists, given that the early spectrum of clinical and CT findings can mimic the more common diagnoses of sepsis and stroke.
