Background -In a previous retrospective study of tuberculosis in south London among Asian immigrants from the Indian subcontinent Hindu Asians were found to have a significantly increased risk for tuberculosis compared with Muslims. This finding has been further investigated by examining the role of socioeconomic and lifestyle variables, including diet, as risk factors for tuberculosis in Asian immigrants from the Indian subcontinent resident in south London. Methods -Using a case-control study technique Asian immigrants from the Indian subcontinent diagnosed with tuberculosis during the past 10 years and two Asian control groups (community and outpatient clinic controls) from the Indian subcontinent were investigated. Cases and community controls were approached by letter. A structured questionnaire concerning a range of demographic, migration, socioeconomic, dietary, and health topics was administered by a single trained interviewer to subjects (56 cases and 100 controls) who agreed to participate. Results -The results confirmed earlier findings that Hindu Asians had an increased risk oftuberculosis compared with Muslims. However, further analysis revealed that religion had no independent influence after adjustment for vegetarianism (common among Hindu Asians). Unadjusted odds ratios for tuberculosis among vegetarians were 2-7 (95% CI 1-1 to 6.4) using community controls, and 4-3 (95% CI 1-8 to 10.4) using clinic controls. There was a trend of increasing risk of tuberculosis with decreasing frequency of meat or fish consumption. Lactovegetarians had an 85 fold risk (95% CI 1-6 to 45.4) compared with daily meat/ fish eaters. Adjustment for a range ofother socioeconomic, migration, and lifestyle variables made little difference to the relative risks derived using either community or clinic controls. Conclusions -These results indicate that a vegetarian diet is an independent risk factor for tuberculosis in immigrant Asians. The mechanism is unexplained. However, vitamin D deficiency, common among vegetarian Asians in south London, is known to affect immunological competence. Decreased immunocompetence associated with a vegetarian diet might result in increased mycobacterial reactivation among Asians from the Indian subcontinent.
The chest radiographs of 100 subjects aged 75 or over were studied. 1. There was no radiological evidence of emphysema in any instance, which suggests that the majority of patients with gross emphysema die of it before reaching 75. 2. Unlike other authors, we have been unable to recognise a senile lung pattern. 3. The only consistent changes were those in the bony skeleton. Decalcification of the ribs was generally present, and may have affected the interpretation of the appearance of the lung vessels. Spondylosis in the dorsal region was universal, and significant kyphosis was present in the majority. 4. The increase in the cardiothoracic ratio commonly found was due to shrinkage of the thoracic cage, and not to an increase in the heart size, so that this ratio is of no value in the assessment of cardiomegaly. 5. The lungs from six aged and five young normal subjects were studied. The aged lungs showed a mild degree of panacinar emphysema only without air trapping.
One hundred patients with tracheobronchial tumours were treated with the neodymium YAG (yttrium-aluminium-garnet) or If clearance of the airways was considered inadequate at the first attempt, we were prepared to give up to three sessions of laser treatment during the initial admission to hospital, after which no further treatment was attempted if the patient did not improve. Follow up treatments were given at one to three month intervals, depending on the speed with which symptoms recurred, for as long as further response was seen and breathlessness or haemoptysis remained predominant symptoms.Response to treatment was assessed by the patients' account of their symptoms and by the results of pulmonary function tests, which included peak expiratory flow rate, spirometric values, and a flow-volume loop. Exercise tolerance was measured by the six minute walking test.5 Full pulmonary function testing was not completed in a few of our early patients and could not be performed in some patients because of extreme breathlessness, but peak flow rate was always attempted on the ward with a Wright peak flow meter. These tests were performed before and after treatment and repeated at outpatient sessions and before subsequent treatments. A symptomatic improvement was recorded if the patient said that he or she felt better and if there was an improvement in the six minute walk. Objective improvement was recorded if there was a grea-341 Hetzel, Nixon, Edmondstone, Mitchell, Millard, Nanson, Woodcock, Bridges, Humberstone ter than 25% rise in peak flow rate, since this information was consistently available. Such cases usually showed improvement in spirometric indices and flow-volume loops as well. In patients with an unrecordable peak flow 601 min-' was taken as the starting point for this calculation.In patients treated for haemoptysis diary charts were recorded from the time of admission for assessment for laser treatment. After discharge home records were continued by the patient, who was asked to record each day whether blood had been coughed up and if so how much. An objective response was defined as complete cessation of haemoptysis for at least one month. A symptomatic response was defined as a significant reduction in frequency and quantity of haemoptysis. It was considered unjustifiable to delay treatment for more than a few days to monitor haemoptyses before the first treatment. In patients who were subsequently treated again (for recurrence of haemoptyses after initial good control) it was, however, possible to compare pre-treatment and post-treatment records covering several weeks. Diary charts were also used to help in deciding when further treatment was indicated.The first 14 patients were treated with the argon laser (Spectra Physics), wavelength 488 and 514 nm, output 12 w. All other patients were treated with the neodymium YAG laser (Barr and Stroud or Medilas), wavelength 1060 nm, maximum output 100 w. The laser beam was transmitted through a 200 um quartz (argon) or 600 micron glass (Nd YAG) opti...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.