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A clinical trial carried out to observe the safety and efficiency of folic acid supplements to prevent colorectal adenomas is presented. Its result states that it does not reduce the risk but increase the risk of having colorectal adenomas.

Low-doses of aspirin may prevent colorectal cancer from getting worse, according to a study of 1,121 patients who had recently been diagnosed with colorectal tumors. The progression of the cancer was slower in patients who took 81 milligrams of aspirin, compared to the patients who took 325 milligrams of aspirin or a placebo.

Objective. To prevent early adolescent health risk behaviors and to maintain or improve safety behaviors, we compared the effects of 2 interventions, delivered through pediatric primary care practices. The interventions, based on an office systems' approach, sought to prevent early drinking and smoking or to influence bicycle helmet use, gun storage, and seatbelt safety for children who were followed from fifth/sixth grades through eighth/ninth grades. Design. Settings and Participants. Twelve pediatric practices in New England were paired according to practice size and assigned randomly within pairs to deliver the multicomponent interventions, which built on pediatric primary care clinicians performing as counselors and role models during health supervision visits and other office encounters. Intervention. One intervention arm focused on alcohol and tobacco use. The other intervention arm focused on gun safety, bicycle helmet, and seatbelt use. Office systems provided infrastructure that supported the clinician's role. Clinician messages encouraged family communication and rule setting about the issues of the middle school years. The intervention was initiated during a health supervision visit and continued for 36 months. Both child and parent received quarterly newsletters to reinforce the clinician messages. Outcome Measures. The primary outcomes were ever drinking alcohol, ever smoking, ever using smokeless tobacco, using a bicycle helmet in the previous year, using a seatbelt in the previous 30 days, and guns in the child's home in locked storage. Results. The pediatric practices recruited 85% (N = 3525) of the practices' fifth/sixth grade children and their responding parents. We obtained 36 months' follow-up data on 2183 child-parent pairs. Chart audit verified that the intervention was implemented. Additional data from interviews and surveys showed that parents, children, and pediatric clinicians found the intervention useful. Despite this, comparisons between the 2 study arms show no significant intervention effects in the prevention of alcohol and tobacco use or gun storage or seatbelt safety. There was a negative effect in the alcohol arm. Only bicycle helmet use showed a positive outcome. Conclusion. With rigorous evaluation, 2 office interventions failed to produce desired outcomes. Coordinated multiple settings for prevention interventions are probably necessary. Pediatrics 2002;109:490-497; alcohol, tobacco, seatbelts, bicycle helmets, gun safety, primary prevention, health promotion, behavior change, primary care, randomized controlled trial., ABBREVIATIONS. TIPP, The Injury Prevention Program; OR, odds ratio; CI, confidence interval. Prevention is a widely advocated pediatric primary care activity. (1) Anticipatory counseling is urged for the important risk [...]

A three-year follow-up study of alcohol prevention among 4,406 children showed that neither a comprehensive school curriculum nor a community intervention was successful in preventing adolescent drinking. Predictor variables for drinking are examined and the importance of tolerance and encouragement of drinking by adult role models are noted., The New Hampshire Substance Abuse Prevention Study is a cohort study of 4,406 public school children, who were in elementary school, junior high school or in the tenth grade in [...]

We measured the surface area of the cerebral cortex and its gross morphological subdivisions in 10 pairs of monozygotic twins. Cortical surface area was estimated in vivo using magnetic resonance imaging and three-dimensional computer models of the intra- and extrasulcal pial surface. The means and standard deviations of regional (e.g., gyral), lobar, hemisphere, and total cortical surface area were tabulated for the entire population of 20 young, right-handed adults (10 females, 10 males). To determine whether genotypic differences were associated with morphometric differences, analyses of variance were carried out on each measure across unrelated twin pairs (genotype factor) and within co-twins (birth order factor). Across unrelated pairs, there was wide variation in regional cortical surface area for the left hemisphere (normalized by total cortical surface area, p ≤ 0.0001) but not for the right hemisphere (normalized, p = 0.12). More variation in lobar surface area was also observed for the left hemisphere (normalized, p = 0.05) than for the right (normalized, p = 0.48). Within co-twins, no significant variation in regional surface area or lobar surface area was found for the left or right hemisphere. Although normalized regional and lobar surface area in the left hemisphere differed across unrelated pairs, overall left hemisphere surface area normalized by total cortical surface area did not (p = 0.73). Total cortical surface area normalized by body weight varied across unrelated pairs (p = 0.001) but not within co-twins (p = 0.39). The effects observed across unrelated pairs were not attributable to sex differences. These results suggest: 1) both the total area and folding of the cortical surface are heavily influenced by genetic factors in humans; and 2) the cerebral hemispheres may be differentially affected by genetic influences on cortical morphogenesis, with the language-dominant left cerebral cortex under stronger genetic control than the right., INTRODUCTION Phylogenetic increases in brain size have evolved not as a symmetrical enlargement of the entire brain, but as a disproportionate increase in the size of the cerebral hemispheres involving, [...]

People who have been treated for basal cell and squamous cell skin cancer have a greater risk of developing skin cancer again. Of 1,805 people diagnosed with either basal cell or squamous cell skin cancer between 1980 and 1986, half developed cancer again within five years of their first diagnosis. They were much more likely to develop the same type of cancer - basal cell or squamous - that they had been diagnosed with initially. The risk of developing cancer again was greater in men, older individuals, California residents and those who had previously been diagnosed with cancer more than once. Those who had sensitive skin or skin damaged by the sun were more likely to develop cancer again. Smokers were twice as likely to develop squamous cell skin cancer again; the risk was not as high in former smokers. Squamous cell skin cancer can be deadly; consequently, people with a history of squamous cell skin cancer should be closely followed., Objective.--The primary aims of this study were to assess risk of subsequent basal and squamous cell skin cancer among patients with a prior history of these tumors and to examine these risks in relation to patient characteristics and life-style factors. Design.--Follow-up of participants in a randomized trial of betacarotene as a possible skin cancer preventive agent. Setting.--Clinical centers in Los Angeles, Calif, San Francisco, Calif, Minneapolis, Minn, and Hanover, NH. Participants.--Patients (n= 1805) who were diagnosed as having a basal or squamous cell skin cancer between January 1980 and February 1986 and were free of skin cancer at study entry. Main Outcome Measure.--Time from study entry to first new occurrence of basal and squamous cell skin cancer. Results.--The estimated risk of developing one or more new skin cancers was 35% at 3 years and 50% at 5 years. New skin cancers tended to be of the same cell type as the previous skin cancers. For both basal and squamous cell skin cancer, risk was higher among patients who were male, were over the age of 60 years, had more prior skin cancers, had severe actinic skin damage, or who burned easily with sun exposure. Compared with those who had never smoked, the rate of subsequent squamous cell skin cancer was higher among current smokers (rate ratio, 2.01; 95% confidence interval, 1.21 to 3.34) and former smokers (rate ratio, 1.62; 95% confidence interval, 1.07 to 2.47) and increased with both duration and amount smoked. There was no clear relationship between smoking and basal cell skin cancer; the rate appeared lower among heavy smokers but was unrelated to duration of smoking. Conclusions.--Persons with a prior nonmelanoma skin cancer had a substantial 5-year risk of developing another tumor of the same histologic type. Number of previous skin cancers, solar damage, and skin sensitivity to sun exposure were particularly related to this risk. The increased risk of squamous cell skin cancer associated with cigarette smoking merits further study. (JAMA. 1992;267:3305-3310)