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Cochrane, A L; Moore, F; Baker, I A; Haley, T J
doi: 10.1136/bmj.280.6223.1131pmid: 7427109
Two random samples of women aged 55-64 living in the Vale of Glamorgan and the Rhondda Fach were followed up for 20 years. In each sample heights, weights, serum cholesterol concentrations, and specific causes of death were noted and the Quetelet index (weight/height2) calculated. The two samples were combined for analysis of total mortality. In the combined sample there was a strong positive association between Quetlet index and both total mortality and mortality from ischaemic heart disease. Multiple logistic regression analysis showed that both of these associations were significant, as was the strong positive association between Quetelet index and mortailty from ischaemic heart disease in the samples considered separately. There was no significant association between cholesterol concentration and mortality from ischaemic heart disease in each sample. There was a small negative association between cholesterol concentration and both total mortaility in the combined sample and ischaemic heart disease in the Rhondda Fach sample. These results suggest that the Quetelet index is important for prognosis, whereas the serum cholesterol concentration is not.
Simpson, R J; Tiplady, B; Skegg, D C
doi: 10.1136/bmj.280.6223.1133pmid: 6448650
In a double-blind trial of the effect of zimelidine on weight and appetite 24 obese patients were allocated at random to receive either zimelidine or placebo for eight weeks followed by the alternative treatment for eight weeks. Possible adverse effects were elicited by asking patients at weekly intervals whether they had experienced any symptoms or ailments and recording all such "events" on a special form. A conventional checklist of symptoms was also used. Among 19 patients who completed the trial the two methods of recording yielded similar patterns of events. Of symptoms not on the checklist, insomnia was more common during treatment with zimelidine. Event recording was found to be a practicable and convenient method of detecting possible adverse effects.
doi: 10.1136/bmj.280.6223.1136pmid: 7427112
In an urban general practice serving 7800 patients, all patients presenting over five and a half years with dyspepsia lasting more than two weeks were investigated by fibreoptic endoscopy and cholecystography, and many by barium meal. Of the 393 patients with dyspepsia, 346 completed the investigation: 180 had specific disease of the oesophagus, stomach, duodenum, or gall bladder, including six with carcinoma. Al further 67 had mucosal disease, and only 99 patients had no abnormality. After the first year the number of patients presenting annually and the percentage of patients with specific lesions remained constant. The annual incidence for patients with dyspepsia was about 1% and for patients with specific lesions 0.4%, suggesting that each year those who became symptom free (either spontaneously or because of treatment) were balanced by a similar number who developed symptoms. In contrast to the conclusions of other workers that an "open-access" endoscopy service could not be justified because the number of patients with specific lesins fell during their survey, we suggest that such endoscopy services are indeed worth while for providing an accurate diagnosis of dyspepsia.
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