Food frequency reports in 1967-1969 were compared to frequency reports of the same foods asked retrospectively in 1982-1983 and 1967-1969 for 1184 respondents aged 45-64 years in the Tecumseh ...Community Health Study. The kappa statistic for concordance of the retrospective and baseline reports was used as a summary measure of the individual's ability to reproduce his or her earlier diet report. Reproducibility was estimated for total diet, represented by 83 foods, and for 9 subsets of foods of epidemiologic interest. In bivariate and multivariate analyses, reproducibility was strongly related to stability of diet; those whose diets changed least over the 15-year period had greatest diet reproducibility. Greater total diet reproducibility was also found among men with higher education, among women of less than 110% desirable weight reporting no special diet and among women reporting no medications. Consistent with current models of memory, the retrospective report of diet was strongly related to the current report of diet. Agreement between the retrospective and baseline diet reports was greater than agreement between the current and baseline diet reports. This indicates that, as a proxy for past diet, the retrospective report of diet is superior to the current report. Similar relationships were found for the 9 subset of foods.
This paper describes the method and results of the advanced control system that was implemented on the Sulphide milling circuit. The acceptance and performance achieved may be attributed to the ...approach in implementing the system, as well as the configuration of the fuzzy logic control strategy.
Only a few data on frequency and character of late infectious complications after high-dose therapy (HDT) and autologous blood stem cell transplantation (ASCT) have been published. This prospective ...study was carried out to identify potential predictive factors for late infections (occurring after discharge following HDT) and to clarify the usefulness of prophylactic measures.
Clinical data of 192 consecutive patients treated with HDT and ASCT in a single hospital were analyzed on late infectious complications. After discharge following HDT, the 166 evaluable patients (84 with hematologic malignancies, 82 with solid tumors) had been examined and interviewed on infections every 4-12 weeks after ASCT. For Pneumocystis carinii prophylaxis, inhalation with pentamidine or oral cotrimoxazole was used for 3-4 months following ASCT.
In the first 6 months following ASCT (after discharge) we saw on average one infectious episode per patient (median, range 0-6), usually light infections (mostly banal upper airway infections). 17 patients had to be treated in hospital for infectious (15 of whom with hematologic malignancies), three of whom (only with hematologic malignancies) died in spite of intensive care as a result of pneumonias due to opportunistic causative agents (mainly Pneumocystis carinii PcP). In the second half of the year after ASCT, five patients (with hematologic malignancies) had to be hospitalized due to infections. No further infection-related death occurred. Early documented infections (pneumonia, bacteremia or Clostridium difficile colitis) were associated with an increased risk for late serious infections. Zoster occurred in 18% of patients within 12 months, more frequently after increased pretreatment (25% vs. 11% after less pretreatment), most frequently in patients with relapsed lymphomas (32%).
Significant late infectious complications after ASCT are uncommon. Patients with hematologic malignancies have a significantly increased risk of more serious infections and should be observed carefully. For risk patients with hematologic malignancies and possibly solid tumors, a strict PcP prophylaxis is required. Patients with relapsed lymphomas could possibly be treated preventively against zoster with low-dose aciclovir to reduce the extent of zoster disease. Each patient should be informed carefully that early signs of zoster require an effective zoster treatment as soon as possible.
This study was performed to examine the efficacy and toxicity of the combination of adriamycin (ADR), methylprednisolone (solumedrol), cytarabine (Ara-C), and cisplatin (CDDP) in patients with ...recurrent and refractory malignant lymphomas.
Sixty-five patients with Hodgkin's disease (HD) (n=14) or non-Hodgkin's lymphomas (NHL) (n = 51) were enrolled in the study. The ASHAP therapy consisted of ADR (40 mg/m2 by continuous infusion (CI) over 96 h), methylprednisolone (500 mg i.v., days 1-5), Ara-C (2 g/m2 as a 2-h infusion on day 5), and CDDP (100 mg/m2 by CI over 96 h).
Twenty-five patients (38%) achieved complete remission (CR) and 20 (31%) were taken into partial remission (PR) for an overall response rate of 69%. Thirty-two patients with CR or PR following ASHAP underwent high-dose therapy (HDT) with subsequent hematopoietic stem cell transplantation. After a median follow-up of 52 months, 13 patients are in continuous CR (CCR), the 3-year event-free survival (EFS) was 30% for responders and 21% for all patients. The median overall survival (OS) was 12 months (range 0-70 months), and the OS rate after 3 years was 32%. Unfavorable prognostic factors for EFS and OS by univariate analysis were an elevated value of the serum lactate dehydrogenase and refractory lymphoma. The most frequently observed side effects following ASHAP were leukocytopenia and thrombocytopenia of World Health Organization (WHO) grades III/IV in approximately 80% of all courses. Non-hematological toxicities such as gastrointestinal side effects, infections, mucositis, renal and neurotoxicity occurred more rarely and reached WHO grades III/IV only occasionally. No treatment-related mortality with ASHAP was observed.
ASHAP is an effective and moderately toxic salvage therapy for patients with recurrent or refractory HD and NHL. The results in patients responding to ASHAP and afterwards undergoing HDT with stem cell support are comparable with other established protocols and indicate an improvement in survival if HDT is carried out as intensification.
Agreement between surrogate and subject reports of current food frequencies and other eating habits, smoking behavior and weight was assessed in 1982-1983 for 180 husbands and wives, aged 45 through ...64 years. Agreement was measured by per cent exact agreement and weighted kappa for frequencies of 30 itemized foods or food groups, and for surrogate- and subject-based quintiles of frequencies of eight broad food groups and of vitamin A and C consumption indexes. Surrogate and subject mean frequencies were generally similar, but at the individual level of analysis, agreement varied widely. Agreement was greatest, among the food items and groups, for alcoholic beverages, and among the other items, for smoking status. Extreme misclassification by quintile was very small, but only 40% of persons self-classified in either extreme quintile were similarly classified by their spouses. This level of misclassification may result in the dilution of real relationships between diet and health.
Sixteen days of dietary recall and records collected over 1 year for 228 respondents were compared with an estimate of "usual" diet based on a 116-item food frequency questionnaire (FFQ) for the ...study year. Respondents were white and black men and women aged 24 to 51. Mean energy values for the total group were 2,111 kcal for the recall/records and 2,766 kcal for the FFQ, a 31% difference. The mean food energy and nutrient values obtained by the FFQ were consistently and significantly higher than the mean recall/record values for all four race-sex groups, although the degree of difference varied by nutrient, food group, and demographic characteristics of the respondents. For the nutrients compared, the smallest difference between methods was for protein--27% for the total group. The greatest difference was for vitamin A--123% for the total sample. Sex-race specific correlation coefficients between methods were relatively high for calcium, vitamin C, and iron
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