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- Beral, V, et al.
(author)
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Alcohol, tobacco and breast cancer - collaborative reanalysis of individual data from 53 epidemiological studies, including 58515 women with breast cancer and 95067 women without the disease
- 2002
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In: British Journal of Cancer. - : Springer Science and Business Media LLC. - 1532-1827 .- 0007-0920. ; 87, s. 1234-45
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Journal article (peer-reviewed)abstract
- Alcohol and tobacco consumption are closely correlated and published results on their association with breast cancer have not always allowed adequately for confounding between these exposures. Over 80% of the relevant information worldwide on alcohol and tobacco consumption and breast cancer were collated, checked and analysed centrally. Analyses included 58515 women with invasive breast cancer and 95067 controls from 53 studies. Relative risks of breast cancer were estimated, after stratifying by study, age, parity and, where appropriate, women's age when their first child was born and consumption of alcohol and tobacco. The average consumption of alcohol reported by controls from developed countries was 6.0 g per day, i.e. about half a unit/drink of alcohol per day, and was greater in ever-smokers than never-smokers, (8.4 g per day and 5.0 g per day, respectively). Compared with women who reported drinking no alcohol, the relative risk of breast cancer was 1.32 (1.19 - 1.45, P < 0.00001) for an intake of 35 - 44 g per day alcohol, and 1.46 (1.33 - 1.61, P < 0.00001) for greater than or equal to 45 g per day alcohol. The relative risk of breast cancer increased by 7.1% (95% CI 5.5-8.7%; P<0.00001) for each additional 10 g per day intake of alcohol, i.e. for each extra unit or drink of alcohol consumed on a daily basis. This increase was the same in ever-smokers and never-smokers (7.1 % per 10 g per day, P < 0.00001, in each group). By contrast, the relationship between smoking and breast cancer was substantially confounded by the effect of alcohol. When analyses were restricted to 22 255 women with breast cancer and 40 832 controls who reported drinking no alcohol, smoking was not associated with breast cancer (compared to never-smokers, relative risk for ever-smokers= 1.03, 95% CI 0.98 - 1.07, and for current smokers=0.99, 0.92 - 1.05). The results for alcohol and for tobacco did not vary substantially across studies, study designs, or according to 15 personal characteristics of the women; nor were the findings materially confounded by any of these factors. If the observed relationship for alcohol is causal, these results suggest that about 4% of the breast cancers in developed countries are attributable to alcohol. In developing countries, where alcohol consumption among controls averaged only 0.4 g per day, alcohol would have a negligible effect on the incidence of breast cancer. In conclusion, smoking has little or no independent effect on the risk of developing breast cancer; the effect of alcohol on breast cancer needs to be interpreted in the context of its beneficial effects, in moderation, on cardiovascular disease and its harmful effects on cirrhosis and cancers of the mouth, larynx, oesophagus and liver. (C) 2002 Cancer Research UK.
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| 2. |
- Barnett, A.H., et al.
(author)
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Angiotensin-receptor blockade versus converting-enzyme inhibition in type 2 diabetes and nephropathy
- 2004
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In: New England Journal of Medicine. - 0028-4793 .- 1533-4406. ; 351:19, s. 1952-1961
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Journal article (peer-reviewed)abstract
- BACKGROUND: Few studies have directly compared the renoprotective effects of angiotensin II-receptor blockers and angiotensin-converting-enzyme (ACE) inhibitors in persons with type 2 diabetes. METHODS: In this prospective, multicenter, double-blind, five-year study, we randomly assigned 250 subjects with type 2 diabetes and early nephropathy to receive either the angiotensin II-receptor blocker telmisartan (80 mg daily, in 120 subjects) or the ACE inhibitor enalapril (20 mg daily, in 130 subjects). The primary end point was the change in the glomerular filtration rate (determined by measuring the plasma clearance of iohexol) between the baseline value and the last available value during the five-year treatment period. Secondary end points included the annual changes in the glomerular filtration rate, serum creatinine level, urinary albumin excretion, and blood pressure, the rates of end-stage renal disease and cardiovascular events, and the rate of death from all causes. RESULTS: After five years, the change in the glomerular filtration rate was -17.9 ml per minute per 1.73 m2 of body-surface area, where the minus sign denotes a decrement, with telmisartan (in 103 subjects), as compared with -14.9 ml per minute per 1.73 m2 with enalapril (in 113 subjects), for a treatment difference of -3.0 ml per minute per 1.73 m2 (95 percent confidence interval, -7.6 to 1.6 ml per minute per 1.73 m2). The lower boundary of the confidence interval, in favor of enalapril, was greater than the pre-defined margin of -10.0 ml per minute per 1.73 m2, indicating that telmisartan was not inferior to enalapril. The effects of the two agents on the secondary end points were not significantly different after five years. CONCLUSIONS: Telmisartan is not inferior to enalapril in providing long-term renoprotection in persons with type 2 diabetes. These findings do not necessarily apply to persons with more advanced nephropathy, but they support the clinical equivalence of angiotensin II-receptor blockers and ACE inhibitors in persons with conditions that place them at high risk for cardiovascular events. Copyright © 2004 Massachusetts Medical Society.
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| 3. |
- Karltun, E., et al.
(author)
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Surface reactivity of poorly-ordered minerals in podzol B horizons
- 2000
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In: Geoderma. - 0016-7061 .- 1872-6259. ; 94:04-feb, s. 265-288
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Journal article (peer-reviewed)abstract
- The surface reactivity of mineral soil horizons from three podzolised forest soils in Scandinavia was examined. The amount of accumulated C was low, between 1.8 and 2.3% in the top of the B horizons. Selective extractions in combination with infrared (IR) spectroscopy and transmission electron microscopy (TEM) indicated a predominance of poorly-ordered imogolite-type materials (ITM) in the oxalate extractable fraction in an examined B horizons. The presence of well-ordered imogolite was only indicated in the Nyanget B3 horizon. A large proportion of free Fe was removed by ammonium oxalate. Comparisons of Mossbauer spectra (both at room temperature and at 4.2 K) before and after treatment with ammonium oxalate showed that the oxalate treatment resulted in a removal of a (super)paramagnetic Fe3+ phase? probably ferrihydrite. A comparison of the Mossbauer Fe3+ parameters at room temperature and 4.2 K indicated a close intergrowth of a ferrihydrite-like oxide with a magnetically neutral matrix, e.g., allophane. The specific surface area (SSA) was determined by N-2 adsorption before and after treatment of the samples with acid ammonium oxalate. The loss of SSA after oxalate treatment was considerable in the B horizon where only between 3.8 to 13.38 of the original SSA remained after treatment. The point of zero charge salt effect (PZSE) increased with depth in the B horizon from between 4.4 and 5.1 in the upper horizons to between 5.7 and 7.7 in the lower part of the B horizon. The increased PZSE with depth paralleled a decrease in the ratio of pyrophosphate soluble C to oxalate soluble Fe + Al. The affinity for SO42-. a goad indicator of the presence of active surface hydroxyls, was measured by comparing the H+ buffering capacity of a sample titrated in 2.5 mM Na2SO4 with a sample titrated in 5 mh I NaNO3,. The buffering capacity of the soil in the Na2SO4, electrolyte was well correlated with the amount of oxalate minus pyrophosphate soluble Fe + Al (r(2) = 0.88). The sulphate exchange capacity was considerably higher than CEC, especially in lower parts of the B horizon. The calculated surface area of the oxalate soluble material (OSM) ranged between 74 and 289 m(2) g(-1) and the calculated surface site density of the same material ranged between 0.6 to 3.3 site nm(-2). It was concluded that the surface reactivity in the B horizons is dominated by the poorly-ordered variable-charge oxides resulting in a low capacity to retain cations but a high capacity for adsorption of weak acid anions like SO42- and organic acids.
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