Production of extensive chickpea (Cicer arietinum L.) protein hydrolysates with reduced antigenic activity

Chickpea protein isolate was used as starting material for the production of hypoallergenic protein hydrolysates. Western blotting of the protein isolate showed that IgE in sensitized patient sera strongly bound to the basic polypeptidic chains and recognized the acidic ones of 11S globulin. During the hydrolysis process by the individual and/or sequential action of endo- and exoproteases, a high reduction of antigenic activity was observed. Results suggest that the presence of intact or partially hydrolyzed basic polypeptide chains of 11S globulin are responsible for the formation of IgE complexes in protein hydrolysates obtained by exoprotease treatment; however, the digestion of these polypeptide chains by individual action of endoprotease caused a high loss of antigenic activity. The most effective reduction of antigenicity, >90%, was observed in extensive hydrolyzed chickpea proteins obtained by sequential treatment with endo- and exopeptidases. This chickpea protein hydrolysate could be useful for the elaboration of specialized hypoallergenic food products.

Purification and partial characterization of chickpea 2S albumin

A chickpea 2S albumin has been purified by solubilization in 60% methanol and ion-exchange chromatography. Under denaturing conditions it is composed of two peptides of 10 and 12 kDa. Native molecular mass determined by gel filtration chromatography is 20 kDa. Amino acid composition shows that it is rich in sulfur amino acids, mainly cysteine with 4.6% of the total. On the other hand, it has antinutritional characteristics of being allergenic for chickpea-sensitive individuals and inhibitory against porcine chymotrypsin with a lesser degree toward trypsin. The results of interest from a nutritional point of view are discussed.

Interaction of chickpea (Cicer arietinum L.) legumin with oxidized linoleic acid

Chickpea legumin has been purified and incubated under oxidizing conditions with linoleic acid to investigate the influence of this acid on the structure and nutritional quality of the protein. At the end of the incubation time, >30% of the linoleic acid was oxidized. The oxidized linoleic acid was highly detrimental to legumin, and the electrophoretic pattern of the protein was completely changed after the incubation period. Nevertheless, neither polymerization nor cleavage of the protein was observed as deduced from gel filtration chromatography, suggesting that the changes observed in native electrophoresis were probably due to oxidation of legumin. The incubation of legumin with linoleic acid also produced a diminution of the contents of methionine and histidine, by 81.3 and 24.3%, respectively. Finally, in vitro protein digestibility of chickpea legumin was also seriously affected by the incubation with linoleic acid, decreasing from 84.1 to 69.2%.

[Prevalence of obesity in Spain: the SEEDO'97 study. Spanish Collaborative Group for the Study of Obesity]

BACKGROUND

The weight distribution of a random sample of Spanish population aged 25-60 years is described. The prevalence of obesity and overweight is estimated by sex, age group and cultural level.

SUBJECTS AND METHOD

Weight, height and waist to hip ratio (WHR) were measured on 5,388 subjects aged 25-60 yr who participated in population Nutritional surveys carried out in four Spanish autonomous regions (Cataluña, País Vasco, Madrid and Valencia) from 1989 to 1994. They were pooled together in order to build a national random sample. The sample was classified according to body mass index (BMI) (weight in kg/height in m2). Obesity was defined as BMI > or = 30 kg/m2. The prevalence of obesity by sex, age group and cultural level was estimated. Risk values for WHR were defined as WHR > 1 for men and WHR > 0.9 for women.

RESULTS

The prevalence of obesity was 13.4%, 11.5% among men and 15.2% among women. Obesity increased with age in men and women, from 5.3% in the 25-34 yr group to 26.3% in the age group 55-60. Among those with a BMI > or = 30, 30.7% of men and 25.1% of women had also risk values for WHR. Educational level showed an inverse relationship with obesity, thus obesity was higher in less educated groups, particularly among women (p < 0.001). The geographical distribution of obesity showed a south-southeast trend, significant for males (p < 0.001).

CONCLUSIONS

Prevalence of obesity in Spain was 13.4%, higher after 45 yr of age, particularly in women and less educated groups.

Prospective cohort study of female sex workers and the risk of HIV infection in Alicante, Spain (1986-96)

OBJECTIVE

To measure the incidence of HIV infection over a 10 year follow up in a cohort of female commercial sex workers in Alicante (Spain), and to determine factors associated with high risk of infection.

METHODS

A prospective cohort study was carried in an AIDS information and prevention centre in Alicante, Spain. Of the 1388 female sex workers who initially sought the services of the centre since September 1986, 657 completed at least one additional follow up visit before December 1996. Main outcome measures were infection with HIV-1 and reported risk behaviours.

RESULTS

During 1815 person years of observation among 657 female sex workers who were free of HIV infection (negative test), 16 women developed of HIV infection (incidence rate of HIV infection = 8.8 cases/1000 woman years, 95% confidence interval (CI): 5.4-14.4). Reported current use of injecting drugs at the first visit was associated with an increased risk of HIV infection (relative risk, RR = 12.87, 95% CI: 4.81-34.15) as well as having an usual partner with injecting drug addiction (RR = 20.89, 95% CI: 7.44-58.70). Infection also was associated with younger age (RR for 1 year = 0.86, 95% CI: 0.76-0.96). After multivariate adjustment using Poisson regression analysis, the factors that remained significantly associated with the risk of HIV infection were current use of injecting drugs (RR = 4.61, 95% CI: 1.37-15.46), and having a usual partner with injecting drug addiction (RR = 10.08, 95% CI: 2.94-34.57). There was also some evidence that a younger age could be related to infection.

CONCLUSION

These data suggest that the risk of HIV infection among this cohort of female sex workers in Alicante is predominately associated with the use of injecting drugs, and having a regular partner with injecting drug addiction. An increasing number of clients did not play a role in the risk of infection.

[Factors associated with the knowledge, treatment, and control of arterial hypertension in an adult population of the community of Valencia]

OBJECTIVE

To identify the level of hypertension awareness, treatment and control in the adult population (14 years and older) at the Valencian Region. Type of treatment and associated factors to the hypertension awareness will be also explored.

DESIGN

Cross-sectional study (population survey).

SETTING

Valencian Region, Spain.

PARTICIPANTS AND MEASUREMENTS

Data from this study are based on a representative sample of the adult population collected for the Nutrition and Health Examination Survey carried out in the Valencian Region in 1994. Blood pressure measurement was based in two readings on each person at a single sitting.

RESULTS

Awareness of hypertension among subjects classified as hypertensive was 50%. The frequency of treated patients among all those subjects who knew as hypertensive, was 85%. The proportion of well controlled among treated hypertensive people was lightly higher than 50%. 14.6% of people aware of being hypertensive were not under treatment.

CONCLUSIONS

The rule of halves still applies to the Valencian Region, though the proportion of diagnosed hypertensive under treatment is much better (> 85%).

[Prevalence and control of arterial hypertension in the adult population of the Valencian community, 1994]

BACKGROUND

High blood pressure (HBP) is probably one of the main targets for prevention in primary health care. Knowledge of the magnitude and control is needed for monitoring this health problem at the population level. The aim of this study was to estimate the prevalence of hypertension in the adult population of Valencian Region (VR) (Spain), and to evaluate the degree of treatment and control.

SUBJECTS AND METHODS

Two measurements of blood pressure (BP) were obtained for a representative sample of 1,674 participants (14 years and older) in the nutrition and health survey of the VR in 1994. A semi-automatic digital esfingmomanometer was used. HBP definition was based on the criteria of the WHO and the Fifth Joint National Committee on Detection Evaluation and Treatment on HBP. Criteria of the MONICA project were used to determine the level of treatment and control of hypertension. Prevalence of HBP was estimated for sex and age groups accounting for the study design.

RESULTS

HBP prevalence was 31.7% (14.1% borderline HBP plus 17.6% defined HBP). Hypertension increased with age from a prevalence of 9.3% in the group 15-24 years of age, to 68.8% in the group > or = 65 years old. A 57% of hypertensive persons were not under treatment, a 16.6% were treated but their BP was not controlled, and a 26.4% were under treatment and presents controlled BP. The uncontrolled BP was more evident at younger ages.

CONCLUSIONS

This study has shown that one third of the adult population from VR had HBP, and over the half of them are not treated. Furthermore, over one third of hypertensives under pharmacological treatment presented uncontrolled BP. These results should be taken into account if preventive actions are to be implemented at the individual and population level.

[Quality and life style as risk factors in acute cerebrovascular disease]

INTRODUCTION

In some series of patients with acute cerebral vascular disease (CVD) it has been seen that, prior to the episode of CVD, the patients already had a poorer quality of life than other people of their age. The object of this study is to evaluate their previous life style and quality of life as risk factors (RF) in acute CVD.

MATERIAL AND METHODS

A case-control study was done of a total of 151 patients admitted to two hospitals with acute CVD and 151 persons, who were not hospitalized and acted as the control group, paired (one to one) for age, sex and hospital. In both groups data were collected regarding basic general health, previous quality of life (Nottingham Health Profile-NHP-, life style and self-perception of social support. The relative risks were estimated by calculating the odds ratios and conditional logistic regression.

RESULTS

Regular moderate physical exercise acts as a protective factor with an OR of 0.32 (IC 95%: 0.14-0.76). Consumption of tobacco and alcohol increased the risk of CVD but did not reach statistical significance. No relationship was found between perceived social support and risk of CVD. Physical mobility, evaluated using the NHP showed a statistically significant negative association with acute CVD (OR: 0.32; IC 95%: 0.14-0.71).

CONCLUSIONS

Our results seem to suggest that the previous overall quality of life cannot be considered a RF in acute CVD, except for physical mobility as evaluated on the NHP. Reduction of this constitutes a RF and moderate physical exercise behaves as a protective factor.

[Stressful life events as risk factors in acute cerebrovascular disease]

INTRODUCTION

The influence of psychosocial stress on the origin of acute cerebral vascular disease (CVD) has received very little attention. The objective of this paper is to evaluate the role of psychosocial stress due to events occurring in daily life as a risk factor (RF) in acute CVD.

MATERIAL AND METHODS

A case-control study was done of a total of 151 patients who were admitted to two hospitals with acute CVD and 151 persons, who where not hospitalized and acted as the control group, paired (one to one) for age, sex and hospital. In both groups data were collected regarding basic general health, consumption of tobacco and alcohol and stressful incidents (SI) in their lives during the previous two years. The stress derived from SI was measured on the 'Inventory of SI and Recent Experiences' of Holmes and Rahe. The frequency of serious SI was also considered. The relative risks were estimated by the odds ratio calculations.

RESULTS

A positive association was found for the RF defined in relation to acute CVD. We did not find any relationship between psychosocial stress derived from SI and risk of acute CVD (either when considering scores on the Holmes and Rahe Inventory or evaluation of serious SI).

CONCLUSIONS

Psychosocial stress from SI does not seem to represent a RF in acute CVD.

Resolution and purification of an aldehyde-generating and an alcohol-generating fatty acyl-CoA reductase from pea leaves (Pisum sativum L.)

Higher plant tissues produce both wax esters generated from fatty alcohols and hydrocarbons generated from fatty aldehydes. If two different reductases are responsible for the synthesis of aldehydes and alcohols, both types of reductases may be present in such tissues. To test for this possibility, pea leaves, known to produce both types of wax components, were examined. Subcellular fractionation showed that acyl-CoA reductase activities were localized mainly in the microsomal fraction. Fatty aldehyde formation was rectilinear for 30 min and subsequently decreased, whereas fatty alcohol formation remained linear for 2 h. The two activities in the microsomes were differently affected by pH; alcohol formation was optimal between pH 5 and pH 6, whereas aldehyde formation was optimal at around pH 7.5. With solubilized microsomes, protein concentration dependence of alcohol formation showed a sigmoidal pattern, possibly suggesting inhibition by hexadecanoyl-CoA at low protein concentrations. Bovine serum albumin (BSA) enhanced alcohol formation. In contrast, the aldehyde generation showed a typical protein concentration dependence, and BSA severely inhibited aldehyde generation. Phosphatidylcholine showed over twofold stimulation for alcohol formation, whereas aldehyde formation was only slightly stimulated. All of this biochemical evidence suggested the presence of two different reductases. Confirming this hypothesis, an aldehyde-generating and an alcohol-generating reductase were resolved from the solubilized microsomal proteins using Blue A agarose, gel filtration, and hexadecanoyl-CoA affinity chromatography. SDS-PAGE of the purified proteins showed that the alcohol-generating enzyme was a 58-kDa protein and the aldehyde-forming one was a 28-kDa protein. It is proposed that two different elongating systems are functionally coupled to the alcohol-generating and aldehyde-generating reductases, which in turn are coupled to the transacylase to produce wax esters and to the decarbonylase to produce hydrocarbons, respectively.

[Income, percent of women living in rural areas, parity, and breast cancer mortality in Spain, 1975-1991]

BACKGROUND

The aim of the present study was to analyze breast cancer mortality by provinces in Spain during the period 1975-91, and to assess the relationship with the geographical distribution of income level, percent of women living in rural areas and average parity of women in each province.

SUBJECTS AND METHODS

Data were obtained from national statistical sources. Standardized mortality ratios (SMR) for breast cancer were estimated by provinces for the periods 1975-1980, 1981-1986 and 1987-1991, and for the whole period 1975-1991. Poisson regression analysis was used to explore the association between breast cancer mortality and the above mentioned variables. Provinces were categorized according to the quintile distribution of independent variables, and ecological relative risks were estimated for each category.

RESULTS

Higher SMR were observed in island provinces (Canary and Balearic island), Catalonia, Basque Country, Navarre and the provinces of Saragosa, Seville and Valencia. Lowest SMR were observed in the inner provinces of Spain and the east part of Andalusian region. This pattern has remained very similar along the study period: income level showed a positive association with mortality from breast cancer. On the contrary, percent of women living in rural areas and parity were negatively associated to breast cancer mortality. The relative risk estimated for each child of parity adjusted by the other factors was 0.92 (95% confidence interval: 0.89-0.94).

CONCLUSIONS

The highest mortality from breast cancer in Spain has been observed in those provinces with the highest income level, the lowest percent of women living in rural areas and the lowest parity. These findings at the ecological (provinces) level are in concordance with results from other studies at the individual level, and further supports the hypothesis that for the etiology of breast cancer, environmental factors could play a dominant role.

[Validity of notified anthropometric data for determining the prevalence of obesity]

BACKGROUND

The aim of this study was to evaluate the validity of the anthropometric data declared by participants in the Survey of Nutrition and Health in the Community of Valencia, Spain in 1994 to estimate the prevalence of obesity using the values obtained by direct measurement in the participants themselves as a reference.

METHOD

The characteristics of the people who did not declare their weight and/or height were analyzed. Complete information on self declared and measured weight and height was collected in 1,387 subjects (700 males and 687 females). The mean values and proportion of indexes declared and measured were compared and the sensitivity (S), specificity (SP) and predictive values (PV) of a Quetelet Index (QI) QI >or= 30 kg/m2 were estimated to detect obesity in reference to the measured values.

RESULTS

Those who did not declare their weight and/or height demonstrated a higher prevalence of obesity than those who did; 27.9% versus 13.1%, the difference being statistically significant (p < 0.001). The subjects who did declare were found to underestimate their weight, overestimate their height and thus, underestimate their relative weight (RW). This phenomenon was found to be greater in women and in older subjects. The prevalence of undeclared obesity was 10% versus 16.3% in that measured. The S of QI >or= 30 kg/m2 for screening obesity was 66.5%, being 69.3% in women and 63% in men, with a SP of 98.7% and positive PV of 92.4%.

CONCLUSIONS

The estimation of the prevalence of obesity from a Quetelet Index >or= 30 kg/m2 based on self-reported data leads to a considerable underestimation of this problem at population level therefore questioning its validity.

[Prevalence of obesity in the Valencia community]

BACKGROUND

This paper describes the ponderal distribution of a representative adult population sample of the Community of Valencia (CV) in Spain. Moreover it estimates the prevalence of obesity by sex, age groups and levels of education.

SUBJECTS AND METHODS

Weight and height data obtained by direct measurement of 1.787 participants in the Survey of Nutrition and Health of the CV in 1994 with a representative population sample of adults over the age of 14. Quetelet's index (QI) (QI - kg/m2) was used as ponderal indicator and established populations with Q1 > or = 30 as being obese. The prevalence of obesity was estimated by age groups, sex and level of education adjusted by the age structure of the same sample.

RESULTS

The overall prevalence of obesity was 16.4%, 17.8% in women versus 14.7 in men. The obesity varied with age from 3.7% in the 15-24 age group to 32.4% in the 50-64 age group and 28.6% for the over 65 years age group. Obesity was more frequent in men under 34 years, and in women over 50 years of age. In reference to levels of education, a higher prevalence was observed in individuals with a lower education.

CONCLUSIONS

The results of this study make it evident that the prevalence of obesity in the CV is more than in other autonomous Spanish communities. The frequency of obesity increased with age up to 65 years, and was more prevalent in women and in individuals with lower levels of education.

[Survival in cancer of the breast in Zaragoza (1960-1990) in relation to age, clinical stage and period of time of the diagnosis]

BACKGROUND

The characteristics of a population based series of 3,066 women diagnosed with breast cancer collected by the Cancer Registry of Zaragoza, Spain from 1960 to 1990 are herein described. Gross short and long term survival, as well as specific survival were estimated according to age at diagnosis, tumor stage and the period in which the patient was diagnosed.

METHODS

Every patient was followed up to verification of death or to the latest information available up to January 1, 1991. Diagnosis specified in writing in the clinical history and support by surgical or anatomopathologic reports were required. The data concerning place and site of residence and the vital status of the cases were verified by the municipal and civil registries, death certificates and burial registries. The survival curves were estimated by the Kaplan-Meier method, and short and long term survival, by age and tumor stage at diagnosis and the diagnostic period were also evaluated.

RESULTS

Gross survival was estimated as 89.1% in the first year, 50.9% at 5 years, and 34.7%, 28.4% and 20.0% at 10, 15, 20 and 25 years, respectively. Survival at 5 years according to TNM clinical stage classification (UICC-AJC 1978) was 90% for stage I, 69.5% for stage II, 44.6% for stage III and 20.6% for stage IV. The cases diagnosed between 1980 and 1990 presented better survival than those previously diagnosed. The differences were statistically significant in all the cases (p < 0.001, log-rank test).

CONCLUSIONS

A slight improvement has been observed in the survival of women diagnosed with breast cancer in Zaragoza, Spain during the study period. Despite of that fact, the survival rates were worse than those observed in other countries with similar socioeconomic development.

[The distribution of cervical cancer mortality in Spain (1981-1986). An ecological study]

BACKGROUND

The aim of the present study was to analyze the geographic distribution of mortality by cervical cancer in Spain from 1981-1986 and to examine the relationship with a group of variables such as per capita income, the occurrence of sexually transmitted diseases, the number of hotel rooms, and the prescriptions of oral contraceptives at a provincial level.

METHODS

The causes standardized of death for cervical cancer in each Spanish province during the period from 1981 to 1986 were estimated. Multivariate analysis by Poisson regression was performed to determine the relationship between mortality and the variables collected. To do so the provinces were classified into four categories according to quartile distribution of each independent variable considered with the relative risk for each category created being estimated.

RESULTS

A characteristic mortality pattern was observed in cervical cancer with the greatest mortality being found in the island and some coastal provinces and the lowest mortality in the peninsular inland provinces. Upon simple analysis of the relationship of mortality with the ecologic variables an important positive association was found with the number of hotel rooms and, to a lesser degree, with the oral contraceptive prescriptions, provincial per capita income, the percentage of urban population and the rate of illiteracy.

CONCLUSIONS

A distribution of mortality by cervical cancer which appears to correspond to a certain leisure-tourism pattern, in addition to greater urban and lesser cultural development is reported. This may be in agreement with the hypothesis that cervical cancer is more frequent in more urban areas in which women demonstrate greater promiscuity and relaxation of sexual behaviours, together with the persistence of a low education level.

[Vaccination coverage in the districts of the city of Castellon and the relationship with sociodemographic factors: an ecologic study]

BACKGROUND

The state of vaccination in 1987 of those born in the city of Castellon and the relation with a group of sociodemographic variables by districts collected from a study based on the census of inhabitants of 1986 was analyzed.

METHODS

The state of vaccination of each child was obtained from the Computerized Municipal Registry of Vaccinations with good vaccination being considered when the child had received all the doses corresponding to the age of two years (four doses of oral trivalent poliomyelitis and three doses of diphtheria-tetanus-pertussis and one dose of diphtheria-tetanus and one dose of triple virus) and was considered as badly vaccinated when one of the doses had been missed. Following classification of each child according to the district of residence, the effect of the state of vaccination, the sex of the child and the month of birth as well as the group of variables collected in the district (ecologic base), the relative risks were estimated by logistic regression analysis.

RESULTS

Neither the sex of the child nor the month of birth had any relation with the risk of being badly vaccinated. Upon analysis of the effect being born in a determined district had, five presented between two and four times less risk of bad vaccination than that taken by reference (La Vila) and another three presented up to two times more risk. Among the significant predictors of risk of bad vaccination the following were found: crowding, old age, rate of dependence, rate of widowhood, and the proportion of single people, while the percentage of active women and the density of population were protective. In multivariant analysis, only the proportion of single people and the number of active women persisted as significant predictors.

CONCLUSIONS

Although great inequality has been reported in vaccination coverage among the districts of the city of Castellon, the general coverage of the city may be considered as satisfactory in the light of the criteria used and from comparisons with other similar studies. The associations found between bad vaccination and some sociodemographic variables by districts (proportion of single people, and active women) together with possible methodologic limitations, do not allow the important inequalities found to be satisfactorily explained.

[The evolution and prediction of the incidence of breast cancer in Zaragoza, 1961-2000]

BACKGROUND

Using the data available from the Cancer Registry of Zaragoza, the incidence of breast cancer in women from 1961 to 1985 was analyzed with future evolution being predicted up to the year 2000.

METHODS

The age, period and birth cohort effects, in addition to the place of residence (capital/rest of province) were analyzed using both, graphic analysis techniques and multivariate models of incidence rates by the Poisson regression. Assuming a constant period effect, the age and cohort effects were used to predict incidence rates in a period of 15 years between 1986 and 2000.

RESULTS

Age-standardized incidence rates increased from 17.1 cases per 100,000 women per year in 1961-1965 to 36.5 in 1981-1985. This increase was mainly observed in women above the age of 40 residing in an urban environment. In a graphic analysis of rates by birth cohorts, an age and cohort effects were observed, producing an anticipation of age to which the highest values in incidence rates were reached. In the prediction of incidence with multivariate models, and increase is foreseen up to the year 2000.

CONCLUSIONS

An increase of breast cancer incidence in Zaragoza has been observed with a further increase foreseen up to the year 2000. This increasing incidence has been related to the age, the year of birth and the place of residence of cases. A relation with some other determinants of disease, and whether the results observed may be extrapolated to the rest of Spain are discussed.

Oesophageal cancer mortality: relationship with alcohol intake and cigarette smoking in Spain

STUDY OBJECTIVE

The aim of the study was to explore temporal changes in mortality from oesophageal cancer that could be related to tobacco and alcohol consumption.

DESIGN

The study used mortality trends from oesophageal cancer over the period 1951-1985. In addition, available trends on per capita consumption of alcohol and cigarettes are also presented.

SETTING

Data for this study were derived from Spain's National Institute for Statistics.

MAIN RESULTS

Age standardised mortality rates from oesophageal cancer have increased significantly among men in Spain from 1951 to 1985 (p less than 0.01). Mortality rates in women have not changed significantly during the same period, although there is evidence of a certain decrease in recent years. Trends of per capita cigarette consumption from 1957 to 1982 related positively with oesophageal cancer mortality among men, whereas no significant relationship was observed in women. Trends of beer, spirits, and total alcohol consumption were also positively correlated with oesophageal cancer mortality in men. Among women, a weaker relationship was found. Wine consumption showed no relationship with oesophageal cancer mortality either in men or women.

CONCLUSIONS

These results are similar to those found in other studies, supporting a role of alcohol (spirits and beer) and cigarette consumption in causation of oesophageal cancer. No relationship was observed with wine consumption.

[Pancreatic cancer and ABO blood types: a study of cases and controls]

BACKGROUND

A hospital-based case-control study (controls were matched to cases by age, sex and hospital) has been carried out to analyze the relation between pancreatic cancer and blood type.

METHODS

This study is based on data collected by the Boston Collaborative Drug Surveillance Programme. This large hospital-based study has been collecting hospital admissions occurred in six different countries. To estimate relative risk (RR) associated with blood type, odds ratios were calculated by multiple logistic regression using conditional maximum likelihood estimation based on the matching factors (age, sex and hospital). The final analysis is based in 108 matched sets (108 cases and 374 controls).

RESULTS

The results indicate a modest excess risk among persons with blood type A (RR = 1.52, 95% confidence interval: 0.87-2.67). Smoking was also a positive predictor of disease.

CONCLUSIONS

In accordance with previous reports, this study shows some evidence of a positive association between blood type A and risk of pancreatic cancer.

Changing mortality patterns for major cancers in Spain, 1951-1985

Mortality trends for main cancer sites in Spain from 1951-1985 are presented. Age-standardized mortality rates per 100,000 were computed using the direct method. The Spanish population of 1970 was used as the standard. Age-standardized mortality rates for total cancer showed a marked increase among men throughout the period of study. This can be attributed mainly to the increase in lung cancer mortality (from 8.63 person-years to 44.74 between 1951 and 1985), which was only partially balanced by a reduction in the stomach cancer mortality (from 36.18 to 18.31). Among women the increase in total cancer is lower overall. It occurred mainly during the 1950s and thereafter the trend has remained stable and even declined in recent years. Lung cancer mortality rates among women have remained fairly stable and stomach cancer followed the same pattern as for men. Breast cancer mortality increased constantly during the period (from 7.21 to 19.38) but it was not until 1978 that it became the leading cause of cancer mortality among women.

[Geographic differences in mortality from digestive tumors in Spain, 1980-1984]

The purpose of this study is to analyze the geographical distribution of eight gastrointestinal (GI) cancer sites in Spain, during the 1980-1984 period. Data for deaths attributed to each cancer site were obtained from Spain's National Institute for Statistics (INE). Standardized Mortality Ratios (SMR) were calculated for each GI cancer site, using the International Classification of Diseases (ICD) 9th revision. Statistical tests were performed to determine whether SMR's were statistically significant. The mortality distribution for cancers of the oropharynx and oesophagus showed a similar pattern, which might suggest some common risk factor in their etiology. Stomach cancer presented high SMR's in the northern central areas (Meseta). Colon, rectum and pancreas cancer sites emerged with irregular patterns though high SMR's were more often observed in developed areas within the country.

A meta-analysis of alcoholic beverage consumption in relation to risk of colorectal cancer

Quantitative methods were used to review epidemiologic data relating consumption of alcoholic beverages to risk of colorectal cancer. The data (27 studies) supported the presence of a weak association. For consumption of two alcoholic beverages daily, on average the relative risk of colorectal cancer was 1.10 (95% confidence interval 1.05-1.14). Other findings were: (1) the association did not vary according to gender or site within the large bowel; (2) results from follow-up studies (relative risk 1.32, 95% confidence interval 1.16-1.51) suggested a stronger relationship than those from case-control studies (relative risk 1.07, 95% confidence interval 1.02-1.12); and (3) the evidence supporting beverage specificity was not conclusive, although the results were consistent with a stronger association with consumption of beer (relative risk 1.26, 95% confidence interval 1.13-1.41) than with consumption of wine (relative risk 1.11, 95% confidence interval 0.91-1.36) or liquor (relative risk 1.13, 95% confidence interval 0.99-1.29). Because the magnitude of the association between alcohol consumption and risk of colorectal cancer was small, the findings regarding a causal role of alcohol were inconclusive.

[Cancer of the pancreas: an ecologic study]

The geographical pattern of mortality due to cancer of pancreas was evaluated in Spain for both sexes, calculating the standardized mortality ratios (SMR) for each province during the period 1975-1980. A multiple linear regression study with a group of environmental variables was carried out. The expenditure on food during the periods 1964-65, 1973-74 and 1980-81 (based on the family budget surveys from the National Institute of Statistics) its volume among these variables. As the most relevant finding, a positive association between death from pancreatic cancer and cheese consumption was observed for the three studied periods: 1964-65 (p less than 0.01 for both sexes), 1973-74 (p less than 0.01 in males) and 1980-81 (p less than 0.02 in males). The validity of these results is analyzed, and an assessment of these studies for the etiological investigation of disease, called ecological studies, is also made.

Trends in mortality from lung cancer in Spain, 1951-80

Lung cancer mortality rates in Spain were calculated for the years 1951 to 1980. Increasing age-standardised rates for men and levelled off ones for women were observed. Available cigarette consumption data suggest that these current trends could change at the beginning of the next century when there may be a levelling off of male rates and an "epidemic" of female lung cancer.