PUBH 6007 PRACTICE QUESTIONS & VERIFIED
ANSWERS
Enstrom JE and Kabat GC: Environmental tobacco smoke and tobacco related
mortality.
OBJECTIVE: To measure the relation between environmental tobacco smoke, as
estimated by smoking in spouses, and long term mortality from tobacco related disease.
In the American Cancer Society cancer prevention study (CPS I) enrolled 118,094
adults in 1959 and followed until 1998. Two of the exposures assessed at baseline in
1959 were smoking in the subject and smoking status of the subject's spouse. This
report focused on the 35 561 "never smokers" who had a spouse in the study with
known smoking habits. RESULTS: For participants followed from 1960 until 1998 the
relative risk for never smokers married to ever smokers compared with never smokers
married to never smokers was 0.94 for coronary heart disease, 0.75 for lung cancer,
and 1.27 for chronic obstructive pulmonary disease. No significant associations were
found for current or - Answers - Prospective cohort study
Valente EA, et al.: The effect of the addition of resistance training to a dietary education
intervention on apolipoproteins and diet quality in overweight and obese older adults.
Clin Interv Aging 2011;6:235-41. Epub 2011 Sep 9.
"The aim of the study was to examine the additive effect of resistance training (RT) to a
dietary education (DE) intervention on emerging coronary heart disease (CHD) risk
factors, concentration of apolipoproteins B (apoB) and A-I (apoA-I), and Dietary
Approaches to Stop Hypertension (DASH) Diet Index scores in overweight and obese
older adults." "Participants were overweight or obese subjects randomized into two
groups, one participating in DE only (n = 12) and the other participating in DE plus RT
(DERT) (n = 15). The intervention involved all subjects participating in 30 minutes of DE
per week for 10 weeks. Subjects in the DERT group participated in an additional 40
minutes of RT three t - Answers - Clinical trial
Janerich et al: Lung cancer and exposure to tobacco smoke in the household. N. Engl.
J. Med. 1990;323:632-6.
These investigators designed a special surveillance system to identify newly diagnosed
patients with lung cancer in selected hospitals within large metropolitan areas in New
York State. They then used medical records and interviews with the patients to identify
patients with lung cancer who were non-smokers (defined as not having smoked more
than 100 cigarettes within the last ten years.) The comparison group consisted of
individuals without known lung cancer. The comparison group was obtained by
selecting drivers randomly from the state database of licensed drivers; they were
matched to the lung cancer patients by age, sex, and county town of residence. All
, subjects were then interviewed to ascertain their total lifetime exposure to household
tobacco smoke from spouses and other family members. Both the freq - Answers -
Case-control study
Severe P, Leger P, et al.: Antiretroviral therapy in a thousand patients with AIDS in
Haiti. N. Engl. J. Med. 2005;353:2325-34. "
BACKGROUND: The one-year survival rate of adults and children with the acquired
immunodeficiency syndrome (AIDS), without antiretroviral therapy, has been about 30%
in Haiti. Antiretroviral therapy has recently become available in Haiti and other
developing countries. Data on the efficacy of antiretroviral therapy in developing
countries are limited. High rates of co- infection with tropical diseases and tuberculosis,
along with malnutrition and limited laboratory monitoring of therapy, may decrease the
efficacy of antiretroviral therapy in these countries. METHODS: During a 14-month
period beginning in March 2003, antiretroviral therapy was initiated in 1004 patients in
Port-au-Prince, Haiti, including 94 children under 13 years of age. RESULTS:
87 percent of adults and adolescents and 9 - Answers - Case series-no comparison
group
Gilliland FD, Berhane K, et al.: Environmental Tobacco Smoke and Absenteeism
Related to Respiratory Illness in Schoolchildren. Am. J. Epidemiology
2003;157(10):861-869.
The children's Health Study enrolled schoolchildren residing in 12 communities within a
200-mile radius of Los Angeles, California. An initial questionnaire completed by the
parents was used to assess the status of the children with regard to many exposures
including environmental tobacco smoke in the home. The outcome of interest for this
particular report was school absences among 2,081 fourth-grade children followed
during the first 6 months of 1996. Tobacco smoke exposure information was collected
by using questionnaire items about the current and past household smoking status of
each participant's mother, father, other adult household members, and regular
household visitors. The current number of household smokers (1, 2, 3, 4, 5, 6 or more)
was - Answers - Prospective cohort study
A Study of Human Papillomavirus and Oropharyngeal Cancer Gypsyamber D'Souza et
al., N Engl J Med 2007;356:1944-56. Infection with sexually transmitted human
papillomavirus (HPV) is a cause of virtually all cervical cancers. DNA of oncogenic HPV
is also detected in about 26% of all squamous-cell carcinomas of the head and neck
worldwide. Evidence of an
association is strongest for oropharyngeal squamous-cell carcinoma, in which
viral integration and the expression of viral oncogenes (E6 and E7) have been shown.
These investigators identified 100 patients who had newly diagnosed squamous-cell
carcinomas of the head and neck in the outpatient otolaryngology clinic of the Johns
Hopkins Hospital in Baltimore from 2000 through 2005. The comparison group
consisted of 200 patients without a history of cancer who were seen for benign
ANSWERS
Enstrom JE and Kabat GC: Environmental tobacco smoke and tobacco related
mortality.
OBJECTIVE: To measure the relation between environmental tobacco smoke, as
estimated by smoking in spouses, and long term mortality from tobacco related disease.
In the American Cancer Society cancer prevention study (CPS I) enrolled 118,094
adults in 1959 and followed until 1998. Two of the exposures assessed at baseline in
1959 were smoking in the subject and smoking status of the subject's spouse. This
report focused on the 35 561 "never smokers" who had a spouse in the study with
known smoking habits. RESULTS: For participants followed from 1960 until 1998 the
relative risk for never smokers married to ever smokers compared with never smokers
married to never smokers was 0.94 for coronary heart disease, 0.75 for lung cancer,
and 1.27 for chronic obstructive pulmonary disease. No significant associations were
found for current or - Answers - Prospective cohort study
Valente EA, et al.: The effect of the addition of resistance training to a dietary education
intervention on apolipoproteins and diet quality in overweight and obese older adults.
Clin Interv Aging 2011;6:235-41. Epub 2011 Sep 9.
"The aim of the study was to examine the additive effect of resistance training (RT) to a
dietary education (DE) intervention on emerging coronary heart disease (CHD) risk
factors, concentration of apolipoproteins B (apoB) and A-I (apoA-I), and Dietary
Approaches to Stop Hypertension (DASH) Diet Index scores in overweight and obese
older adults." "Participants were overweight or obese subjects randomized into two
groups, one participating in DE only (n = 12) and the other participating in DE plus RT
(DERT) (n = 15). The intervention involved all subjects participating in 30 minutes of DE
per week for 10 weeks. Subjects in the DERT group participated in an additional 40
minutes of RT three t - Answers - Clinical trial
Janerich et al: Lung cancer and exposure to tobacco smoke in the household. N. Engl.
J. Med. 1990;323:632-6.
These investigators designed a special surveillance system to identify newly diagnosed
patients with lung cancer in selected hospitals within large metropolitan areas in New
York State. They then used medical records and interviews with the patients to identify
patients with lung cancer who were non-smokers (defined as not having smoked more
than 100 cigarettes within the last ten years.) The comparison group consisted of
individuals without known lung cancer. The comparison group was obtained by
selecting drivers randomly from the state database of licensed drivers; they were
matched to the lung cancer patients by age, sex, and county town of residence. All
, subjects were then interviewed to ascertain their total lifetime exposure to household
tobacco smoke from spouses and other family members. Both the freq - Answers -
Case-control study
Severe P, Leger P, et al.: Antiretroviral therapy in a thousand patients with AIDS in
Haiti. N. Engl. J. Med. 2005;353:2325-34. "
BACKGROUND: The one-year survival rate of adults and children with the acquired
immunodeficiency syndrome (AIDS), without antiretroviral therapy, has been about 30%
in Haiti. Antiretroviral therapy has recently become available in Haiti and other
developing countries. Data on the efficacy of antiretroviral therapy in developing
countries are limited. High rates of co- infection with tropical diseases and tuberculosis,
along with malnutrition and limited laboratory monitoring of therapy, may decrease the
efficacy of antiretroviral therapy in these countries. METHODS: During a 14-month
period beginning in March 2003, antiretroviral therapy was initiated in 1004 patients in
Port-au-Prince, Haiti, including 94 children under 13 years of age. RESULTS:
87 percent of adults and adolescents and 9 - Answers - Case series-no comparison
group
Gilliland FD, Berhane K, et al.: Environmental Tobacco Smoke and Absenteeism
Related to Respiratory Illness in Schoolchildren. Am. J. Epidemiology
2003;157(10):861-869.
The children's Health Study enrolled schoolchildren residing in 12 communities within a
200-mile radius of Los Angeles, California. An initial questionnaire completed by the
parents was used to assess the status of the children with regard to many exposures
including environmental tobacco smoke in the home. The outcome of interest for this
particular report was school absences among 2,081 fourth-grade children followed
during the first 6 months of 1996. Tobacco smoke exposure information was collected
by using questionnaire items about the current and past household smoking status of
each participant's mother, father, other adult household members, and regular
household visitors. The current number of household smokers (1, 2, 3, 4, 5, 6 or more)
was - Answers - Prospective cohort study
A Study of Human Papillomavirus and Oropharyngeal Cancer Gypsyamber D'Souza et
al., N Engl J Med 2007;356:1944-56. Infection with sexually transmitted human
papillomavirus (HPV) is a cause of virtually all cervical cancers. DNA of oncogenic HPV
is also detected in about 26% of all squamous-cell carcinomas of the head and neck
worldwide. Evidence of an
association is strongest for oropharyngeal squamous-cell carcinoma, in which
viral integration and the expression of viral oncogenes (E6 and E7) have been shown.
These investigators identified 100 patients who had newly diagnosed squamous-cell
carcinomas of the head and neck in the outpatient otolaryngology clinic of the Johns
Hopkins Hospital in Baltimore from 2000 through 2005. The comparison group
consisted of 200 patients without a history of cancer who were seen for benign
