The Johns Hopkins medical journal最新文献

A series of educational demonstration programs were designed for selected populations in regard to risk factors for cardiovascular disease. The series, which progressed from clinical trial to public health program, included a project to control high blood pressure (HBP) in outpatients and in a general statewide population, and a school program to decrease dietary intake of salt in 6th grade children at increased risk for HBP. Positive long-term effects in the outpatient study included increased control of HBP and decreased associated mortality, and improvement in compliance with therapy, appointment-keeping and weight-control. Positive short-term effects in both the statewide study and the school population are discussed, and conclusions and implications for behavioral change and public health programs are presented.

Cancer control is the reduction of cancer incidence, morbidity, or mortality through an orderly sequence from research on interventions to systematic application of the results to populations. To help ensure this progression, a system of classifying cancer control research into phases has been developed. These phases are hypothesis development, studies of methods, case-control studies, defined population studies, and demonstration-implementation. Studies of the potential impact of cancer control measures in defined populations are particularly needed. New research support should therefore be provided to research units focusing on this area of cancer control. A new community clinical oncology program will link community physicians with cancer center and university scientists in a cooperative cancer control effort. Another new cancer control program is called chemoprevention research, that is, clinical trials aimed at determining whether selected micronutrients or synthetic compounds can reduce the incidence of cancer.

In an ongoing longitudinal study of former medical students, now physicians in midlife, the prevalence of cancer among relatives of 46 probands affected by cancer has been compared with that of two control groups of cancer-free probands. Overall, the prevalence of cancer among relatives of the three groups of probands was similar. However, male probands with cancer appeared to have a greater prevalence of cancer among their relatives than did male cancer-free probands, while the corresponding comparisons for the smaller groups of female probands showed the opposite tendency. Among the relatives of cancer probands of either sex, there was evidence of familial clustering of cancer. Where two relatives in a proband's family had the same type of cancer, the two relatives were usually on the same side (paternal or maternal) of the family. Ages at onset of cancer and types of cancer in relatives of the cancer and cancer-free probands did not reveal any significant differences.

Diffuse fasciitis with eosinophilia is a newly recognized connective tissue disease appearing initially to be either scleroderma or dermatomyositis. It has clinical and histologic features that allow it to be clearly separated from both disorders and has a more favorable prognosis. The majority of reported cases have been in adults. The disease involves the extremities, and at times the trunk, diffusely. One sees firm, often puckered or rivuleted skin, tightly bound to underlying structures; contractures result in several weeks. Early peripheral blood features are eosinophilia and elevated immunoglobulins. For diagnosis, full-thickness biopsies extending from skin through subcutaneous tissue, fascia, and muscle are taken together as one block. These tissues should not be separated from each other. The diagnostic lesion is in the fascia which is edematous, thickened, and infiltrated by mononuclear cells. The other tissues are completely normal. The clinical response to steroids is prompt and favorable.