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Obesity and lack of physical activity have been inconsistently associated with pancreatic cancer. Using data from a self-administered baseline questionnaire (1995-1996), the authors investigated the association between adiposity and physical activity and pancreatic cancer in 495,035 participants of the National Institutes of Health-AARP Diet and Health Study who were aged 50-71 years. To avoid the influence of subclinical disease, follow-up time started 1 year after baseline, and subjects with a body mass index (BMI) of <18.5 kg/m(2) were excluded. A subcohort (n = 302,060) completed a second questionnaire with information about physical activity and waist and hip circumference. During follow-up though 2000, 654 pancreatic cancer cases were identified. The authors used Cox proportional hazard models to generate adjusted hazard ratios and 95% confidence intervals. Compared with those with a BMI of 18.5-<25, those with a BMI of >/=35 had a 45% greater pancreatic cancer risk (95% confidence interval (CI): 1.04, 2.02; p(trend) = 0.02). Significant positive associations for BMI were observed among nonsmokers (for BMI > or =35: hazard ratio = 1.70, 95% CI: 1.14, 2.53; p(trend) = 0.004) but not recent smokers (p(interaction) = 0.08). Waist circumference was positively associated with pancreatic cancer (fourth vs. first quartile: hazard ratio = 2.53, 95% CI: 1.13, 5.65; p(trend) = 0.04) in women but not men. The authors observed no association with physical activity. Their results suggest a positive association between adiposity and pancreatic cancer. [ABSTRACT FROM AUTHOR]

The attitudes of 233 relatives to autopsy of elderly medical patients (mean age 82 years) who died in a district general hospital were examined prospectively. Forty-three (18%) relatives were asked permission for autopsy, 24 (56%) agreed and 19 (44%) refused. Of 190 (82%) relatives whose permission was not sought, 109 (57%) would have agreed and 81 (43%) would have refused permission had they been asked. Advancement of medicine and reassurance about the correct diagnosis were the main reasons for consent, while dislike of autopsy, family distress at disfigurement of the body and the patient 'having suffered enough' were the main reasons for refusal. Living near rather than with the deceased (64% vs 45%; chi 2 = 6.985, p = 0.01) and being a male rather than female relative (63% vs 49%; chi 2 = 3.879, p = 0.05) were predictive of a positive response to autopsy. Of the 39 autopsies performed, 24 (9.6%) followed relatives' permission and 15 (6%) were at the request of the coroner. The overall autopsy rate of 16% was lower than the rate recommended for medical audit (35%). Although there is a need for educating relatives about the benefits of autopsy, a more urgent study is required to find reasons for the low request by medical staff. [ABSTRACT FROM AUTHOR]

Radiographs of the cervical spine of 32 elderly patients clinically diagnosed as having vertebrobasilar insufficiency secondary to cervical spondylosis were compared with 32 age- and sex-matched controls. The mean age was 77.6 years. There was no significant difference in the severity of the radiological changes between the two groups as judged by the narrowing of disc space and marginal osteophyte formation. It is concluded that there is no place for routine examination of the cervical spine in patients thought to have vertebrobasilar insufficiency secondary to cervical spondylosis. [ABSTRACT FROM PUBLISHER]