Search PubMed⌕ Search

Biomedical subjects

Brian L Strom

Publications and source records attributed to Brian L Strom.

At least 55 records · Page 3Linked to original sources
PubMed2005

Cimetidine and other histamine2-receptor antagonist use in relation to risk of breast cancer.

OBJECTIVE: Cimetidine, a histamine2-receptor antagonist (H2 blocker) commonly used to treat symptoms of peptic and duodenal ulcer, influences both hormonal and immune pathways. We investigated the influence of cimetidine use on the risk of breast cancer in our hospital-based case control surveillance study. METHODS: Data on medication use and other factors were elicited from patients admitted to hospitals from 1977 to 2002. We compared 6,994 breast cancer cases with a control group comprising cancer (n = 2,478) and noncancer (n = 6,004) diagnoses. Conditional logistic regression models were used to estimate odds ratios for H2 blocker use that began at least 1 year prior to admission. Regular use was defined as use for at least 4 days per week for at least 3 continuous months. RESULTS: The odds ratio for breast cancer among regular users of cimetidine was 0.9 (95% confidence interval, 0.6-1.2) using a combined cancer and noncancer control group. For use of 4 or more years' duration, the odds ratio was < 1.0 but was not statistically significant. The odds ratio for the regular use of other H2 blockers was 0.9 (95% confidence interval, 0.6-1.3). CONCLUSIONS: Our data agree with data from three prior studies which indicate that cimetidine is not associated with the risk of breast cancer. Other H2 blockers were also unrelated to the risk of breast cancer.

Adult↗
PubMed2004

Reproductive factors and risk of breast carcinoma in a study of white and African-American women.

BACKGROUND: Few studies have investigated the association between reproductive factors and the risk of breast carcinoma among African-American women. The authors assessed whether the number of full-term pregnancies, age at first full-term pregnancy, and total duration of breastfeeding were associated with similar relative risk estimates in white and African-American women in a large multicenter, population-based case-control study of breast carcinoma. METHODS: Case patients were 4567 women (2950 white women and 1617 African-American women) ages 35-64 years with newly diagnosed invasive breast carcinoma between 1994 and 1998. Control patients were 4668 women (3012 white women and 1656 African-American women) who were identified by random-digit dialing and were frequency matched to case patients according to study center, race, and age. Adjusted odds ratios and 95% confidence intervals were estimated using unconditional logistic regression. RESULTS: For white women, the reduction in risk of breast carcinoma per full-term pregnancy was 13% among younger women (ages 35-49 years) and 10% among older women (ages 50-64 years). The corresponding risk reductions for African-American women were 10% and 6%, respectively. Risk decreased significantly with increasing number of full-term pregnancies for both races and both age categories. Duration of lactation was inversely associated with breast carcinoma risk among younger parous white (trend P = 0.0001) and African-American (trend P = 0.01) women. African-American women tended to have more children compared with white women, but parity rates were lower in younger women than in older women in both racial groups. However, breastfeeding was substantially more common in young white women than in young African-American women. CONCLUSIONS: Overall, parity and lactation had similar effects on breast carcinoma risk in white and African-American women. If younger African-American women now are giving birth to fewer children than in the past, without a substantial increase in breastfeeding, breast carcinoma rates may continue to increase at a more rapid rate among these women compared with white women.

Adult↗
PubMed2004

The effects of nonselective non-aspirin non-steroidal anti-inflammatory medications on the risk of nonfatal myocardial infarction and their interaction with aspirin.

OBJECTIVES: This study was designed to determine if non-aspirin non-steroidal anti-inflammatory drugs (NANSAIDs) are associated with lower odds of myocardial infarction (MI) and if NANSAIDs, particularly ibuprofen, interfere with aspirin's cardioprotective effect. BACKGROUND: The NANSAIDs may reduce the risk of MI but may also interfere with aspirin's cardioprotective effect. METHODS: A case-control study was conducted, with cases of first, nonfatal MI identified prospectively and controls identified randomly from the community. RESULTS: The use of NANSAIDs was associated with a significant reduction in MI among those not using aspirin (adjusted odds ratio [OR] 0.53; 95% confidence interval [CI]: 0.42 to 0.67). This was true for both ibuprofen (adjusted OR 0.52; 95% CI: 0.39 to 0.69) and naproxen (adjusted OR 0.48; 95% CI: 0.28 to 0.82). Although aspirin itself was associated with decreased odds of MI in those not also using NANSAIDs (adjusted OR relative to no aspirin use 0.79; 95% CI: 0.63 to 0.98), it was not associated with decreased odds of MI among those who were using NANSAIDs (OR 1.28; 95% CI: 0.85 to 1.94; p value for interaction = 0.026). The association of aspirin and reduced odds of MI diminished with increasing frequency of NANSAID use (test for interaction p = 0.006), particularly for ibuprofen (p = 0.018). Among frequent (4 times/week) NANSAID users, the OR for aspirin versus no aspirin was 2.04 (95% CI: 1.06 to 3.94). Users of prophylactic aspirin plus frequent ibuprofen had an OR relative to aspirin-only users of 2.03 (95% CI: 0.60 to 6.84). CONCLUSIONS: In the absence of aspirin use, NANSAIDs are associated with reduced odds of MI. In those using aspirin, NANSAIDs do not provide additional protection. Additional study is needed to determine the clinical impact of using NANSAIDs along with aspirin for cardioprotection.

Adult↗
PubMed2004

Longitudinal trends in fluoroquinolone resistance among Enterobacteriaceae isolates from inpatients and outpatients, 1989-2000: differences in the emergence and epidemiology of resistance across organisms.

We conducted a 12-year study to identify and compare trends in annual prevalence of fluoroquinolone (FQ) resistance among Enterobacteriaceae isolates obtained from inpatients and outpatients in our health care system. A total of 46,070 clinical Enterobacteriaceae isolates underwent susceptibility testing. Although there were significant increases in inpatient FQ resistance for all Enterobacteriaceae, FQ resistance trends differed significantly across Enterobacteriaceae (P<.001). For isolates obtained from outpatients, only Escherichia coli and Proteus mirabilis demonstrated significant increases in FQ resistance (P<.001 for each). Trends in outpatient FQ resistance also differed significantly across Enterobacteriaceae (P<.001). There were significant differences between inpatient and outpatient FQ resistance trends for all Enterobacteriaceae except P. mirabilis and Enterobacter cloacae. Although hospital-wide use of certain antibiotics correlated significantly with inpatient FQ resistance, these correlations differed substantially across organisms. Efforts to elucidate the epidemiology of FQ resistance and identify targets for intervention must recognize and account for the variability of FQ resistance across organisms and clinical settings.

Anti-Infective Agents↗
PubMed2004

Cigarette smoking and increased risk of mucinous epithelial ovarian cancer.

Several studies have reported that cigarette smoking is associated with an increased risk of mucinous ovarian cancer, but other studies have failed to find such a relation. Using data from the Case-Control Surveillance Study, begun in four US cities in 1976, the authors conducted a case-control study (1976-2001) to examine the association between cigarette smoking and the risk of ovarian cancer of different cell types. Among 709 incident cases of epithelial ovarian cancer, 402 were serous, 74 were mucinous, 106 were endometrioid, and 127 were of other cell types. For mucinous ovarian cancer, the odds ratios were 1.5 (95% confidence interval (CI): 0.7, 3.4) among women who smoked less than one pack of cigarettes per day, 1.4 (95% CI: 0.6, 3.5) among women who smoked one pack per day, and 2.9 (95% CI: 1.2, 7.5) among women who smoked more than one pack per day, relative to never smokers. The odds ratios were 2.5 (95% CI: 1.1, 5.4) for ex-smokers and 1.4 (95% CI: 0.7, 2.9) for current smokers. While women with up to 15 pack-years of smoking had an almost 2.5 times' increased risk of mucinous ovarian cancer, such an increased risk was not found among those with more than 15 pack-years of smoking. There was no association between cigarette smoking and epithelial ovarian cancer of other cell types. Despite inconsistencies in the data, these results strengthen the evidence that cigarette smoking may play a role in the development of mucinous ovarian cancer but not ovarian cancer of other cell types.

Adenocarcinoma, Mucinous↗
PubMed2004

Absence of an effect of injectable and implantable progestin-only contraceptives on subsequent risk of breast cancer.

Animal data indicate that both estrogens and progestins could be carcinogenic and that progestins could serve as tumor promoters. Human studies have not confirmed an increased risk of breast cancer from long-term use of oral contraceptives, but have shown an increased risk from hormone replacement therapy including progestins. The present study analyzed the relationship between breast cancer and use of injectable and implantable progestin-only contraceptives. Analyses were performed on data collected in a population-based, multicenter, case-control study, the Women's Contraceptive and Reproductive Experiences Study of the National Institute of Child Health and Human Development. The study involved 4575 randomly sampled cases with invasive breast cancer diagnosed between 1994 and 1998, and 4682 controls, identified using random digit dialing. We assessed the association between exposure to injectable contraceptives and risk of breast cancer. The use of injectable contraceptives was not associated with an increased risk of breast cancer [odds ratio (OR) = 0.9, 95% confidence interval (CI): 0.7, 1.2]. Risk was not increased among current users, defined as women who used injectable contraceptives within 1 year of the reference date (OR = 0.7, 95% CI: 0.4, 1.3) or those who initiated use in the 5 years immediately preceding the reference date (OR = 0.9, 95% CI: 0.5, 1.4), or with use beginning before age 35 (OR = 0.9, 95% CI: 0.6, 1.3). Among users, risk increased with increasing duration of use (p = 0.03). However, short-term users (<6 months duration) were at decreased risk relative to never users (OR = 0.6, 95% CI: 0.4, 1.0). When the short-term users were then excluded from the duration-response analysis, the slope of the duration-response became slightly (and nonsignificantly) negative. Risk was not increased among women with 24 or more months of use relative to never users (OR = 1.4, 95% CI: 0.8, 2.5). No increased risk was seen from implantable contraceptives either, although the sample sizes were small. This study does not support an increased risk of breast cancer associated with the use of injectable or implantable progestin-only contraceptives in women aged 35 to 64.

Absorbable Implants↗
PubMed2004

Represcription of penicillin after allergic-like events.

OBJECTIVE: We sought to determine the frequency of represcription of penicillin to individuals with penicillin allergy and the risk of a second reaction in those who had a previous reaction. METHODS: A retrospective cohort study was conducted within the UK General Practice Research Database. All patients who had received a prescription for penicillin were identified. Within that source population, records of patients who had received at least 2 prescriptions for penicillin at least 60 days apart were selected and examined for allergic-like (hypersensitivity) events on the day of or within 30 days after a prescription. RESULTS: At least one prescription for penicillin was given to 3,375,162 patients. Of 6212 (0.18%) patients who experienced an allergic-like event after the initial prescription, 48.5% were given a second prescription compared with 59.8% of those without an initial allergic-like event (risk ratio, 0.81; 95% CI, 0.79-0.83). Two or more prescriptions for penicillin were given to 2,017,957 patients. Three thousand fourteen (0.15%) patients experienced an allergic-like event after the first prescription, and 57 (1.89%) of those had another event after the second prescription. The unadjusted odds ratio of an allergic-like event after the second prescription for those who experienced an allergic-like event after the first prescription, compared with those who had no initial event was 11.2 (95% CI, 8.6-14.6). Adjusting for confounding had no substantive effect on this result. CONCLUSION: The risk of an allergic-like event after penicillin is markedly increased in those who have had a prior event, although the absolute difference is small (1.72%). Represcription of penicillin to such patients is more frequent than anticipated.

Adolescent↗
PubMed2004

Rhinitis therapy and the prevention of hospital care for asthma: a case-control study.

BACKGROUND: Although clinical trials have demonstrated that rhinitis therapy improves subjective and objective measures of asthma, it is uncertain whether treatment of allergic rhinitis significantly affects the frequency of asthma exacerbations. OBJECTIVE: The objective of this study was to determine whether treatment with intranasal corticosteroids and/or second-generation antihistamines is associated with changes in rates of asthma exacerbations resulting in emergency room visits and/or hospitalizations in patients with asthma and allergic rhinitis. METHODS: This was a nested, case-control study. RESULTS: Treatment with either nasal corticosteroids or second-generation antihistamines was associated with a lower risk of asthma-related emergency room treatment and hospitalization (adjusted odds ratio [OR], 0.51; 95% CI, 0.34 to 0.77 and 0.34, 0.18 to 0.62, respectively). Patients who used nasal corticosteroids had a significantly lower risk of both asthma-related emergency room treatment and hospitalization (adjusted OR, 0.75; 95% CI, 0.62 to 0.91 and 0.56, 0.42 to 0.76, respectively), whereas there was a trend toward lower risk of emergency room treatment and hospitalization in patients who used second-generation antihistamines (adjusted OR, 0.88; 95% CI, 0.62 to 1.26 and 0.68, 0.40 to 1.14, respectively). Combined treatment with both medications was associated with a further lowering of the risk of both emergency room treatment and hospitalization (adjusted OR, 0.37; 95% CI, 0.19 to 0.73 and 0.22, 0.07 to 0.63). CONCLUSIONS: In patients with asthma, treatment of concomitant allergic rhinitis was associated with significant reductions in risk of emergency room treatment and hospitalization for asthma.

Administration, Intranasal↗
PubMed2004

Participants and refusers in a telephone interview about hormone replacement therapy were equally likely to be taking it.

OBJECTIVE: To address a major concern in pharmacoepidemiology studies related to whether the characteristics of responders are different from those who refuse to participate. STUDY DESIGN AND SETTING: We compared utilization of postmenopausal hormone replacement therapy (HRT) in women who agreed to participate in a telephone interview on HRT utilization and in women who refused to participate in the telephone interview. Information on HRT utilization among responders and refusers was independently available to us from a claims database (the Healthcare Management Alternatives, HMA, in Philadelphia), showing drugs dispensed to these patients. RESULTS: Out of a random sample of 213 women selected from the claims database whom we contacted, 154 (72.3%) women agreed to participate and 59 (32.7%) women refused. Among the 154 women who agreed to participate, 79 (51.3%, 95% CI: 43.1-59.4%) were shown by the database to have been dispensed an HRT during the 15-month period January 1995 through March 1996. Among the 59 women who refused to participate, 30 (50.8%, 95% CI: 37.5-64.1%) were shown by the database to have been dispensed an HRT during the same period. CONCLUSION: Thus, we have evidence that use of HRT was almost identical in responders and nonresponders.

Estrogen Replacement Therapy↗
PubMed2004

An interview strategy was critical for obtaining valid information on the use of hormone replacement therapy.

OBJECTIVE: We compared telephone reports of hormone replacement therapy (HRT) use to claims for drugs dispensed. STUDY DESIGN AND SETTING: The study subjects included 106 women who were dispensed HRT and 107 who were not dispensed HRT. RESULTS: Recall of drug use overall was relatively good (65/79=82.3%, 95% confidence interval [CI] 73.9-90.7). Agreement between recall of drug name and the claims for dispensed drugs was lower (61/79=77.2%, 95% CI 68.0-86.5). Of 65 women reporting use of HRT in response to the indication prompt, nine (13.8%) could not identify the drug name using the drug list prompt, but all 65 women identified a drug using the photo prompt. Recall of start date of drug use was poor (29.2% agreement on month/year; 45.8% agreement within 1 month), and recall of end date of drug use was poorer yet (7.7% agreement on month/year; 21.5% agreement within 1 month). CONCLUSION: Recall of drug use and drug names is far better than recall of dates of use. Recall can be enhanced with lists of drug names and color photos, but even with memory prompts, recall remains imperfect. If drug use is the primary exposure of interest in a study, considerable effort is needed to collect it correctly. If not, then perhaps drug histories should be omitted.

Age Factors↗
PubMed2004

Statistical problems encountered in trapping studies of scolytids and associated insects.

Traps baited with semiochemicals are often used to investigate the chemical ecology of scolytids and associated insects. One statistical problem frequently encountered in these studies are treatments that catch no insects and, thus, have zero mean and variance, such as blank or control traps. A second problem is the use of multiple comparison procedures that do not control the experimentwise error rate. We conducted a literature survey to determine the frequency of these two statistical problems in Journal of Chemical Ecology for 1990-2002. Simulations were then used to examine the effects of these problems on the validity of multiple comparison procedures. Our results indicate that both statistical problems are common in the literature, and when combined can significantly inflate both the experimentwise and per comparison error rate for multiple comparison procedures. A possible solution to this problem is presented that involves confidence intervals for the treatment means. Options to increase the statistical power of trapping studies are also discussed.

Animals↗
PubMed2004

Seasonal variation in flares of inflammatory bowel disease.

BACKGROUND & AIMS: Previous research has yielded conflicting data as to whether the natural history of inflammatory bowel disease follows a seasonal pattern. The purpose of this study was to determine whether relapse of inflammatory bowel disease follows a seasonal pattern either across a cohort of patients or within individual patients. METHODS: We used 1988 to 1997 data from the General Practice Research Database to conduct a retrospective cohort study of 1587 patients with Crohn's disease (mean age at start of follow-up, 41 +/- 17 years) and 2773 patients with ulcerative colitis (mean age at start of follow-up, 48 +/- 16 years). Flares of disease were identified by receipt of a new prescription for either corticosteroids or 5-ASA medications following an interval of at least 4 months without prescriptions for either class of medication. Logistic regression was used to adjust the association of season of the year and flare of disease for potential confounding variables. RESULTS: There was no association between season of the year and flare of Crohn's disease (P = 0.66). Season of the year was only weakly associated with flares of ulcerative colitis (P = 0.02). Compared with winter, spring had very slightly higher rates of flares (OR = 1.13, 95% CI: 1.05-1.23). We did not observe seasonal patterns within individual patients experiencing multiple flares (P > 0.05 for Crohn's disease and ulcerative colitis). CONCLUSIONS: Although we observed a slight increase in exacerbations of ulcerative colitis in the spring, in general, these data do not support an association between season of the year and flares.

Adrenal Cortex Hormones↗
PubMed2004

Preevent vaccination against smallpox: a survey of pediatric emergency health care providers.

BACKGROUND: In January 2003, smallpox vaccinations were offered to health care workers to create hospital-based teams prepared to care for patients with smallpox as part of national bioterrorism preparedness activities. METHODS: An anonymous survey of pediatric emergency health care workers was conducted in November and December 2002. Two mailings were sent to physicians, nurses and ancillary staff at five academic pediatric emergency departments in major US cities. We assessed the willingness to receive preevent smallpox vaccine. In addition we measured the prevalence of vaccine contraindications, perceived likelihoods of a local smallpox outbreak or a vaccine-related adverse event and reasons for or against wanting to receive the vaccine. RESULTS: Overall 72% of respondents were willing to receive the smallpox vaccine. Individuals who were willing to receive the smallpox vaccine, compared with those not willing, believed a local outbreak was more likely to occur (odds ratio, 1.29; 95% confidence interval, 1.16 to 1.44). One-fifth of respondents reported a contraindication to smallpox vaccine; however, more than half indicated they would still be willing to receive vaccine. Individuals who perceived themselves at high risk for vaccine-related adverse events were less willing to receive the preevent smallpox vaccine. Self-protection was the most common reason cited for wanting to receive the vaccine. CONCLUSIONS: A majority of pediatric healthcare workers were willing to receive preevent smallpox vaccine before the onset of Phase I of the CDC Smallpox Vaccination Program. A greater understanding of the knowledge, attitudes and beliefs of pediatric health care workers toward preevent smallpox vaccination will assist in the development of future bioterrorism preparedness programs.

Attitude of Health Personnel↗
PubMed2004

Patterns of complementary and alternative medicine use in a population of pediatric patients with inflammatory bowel disease.

Complementary and alternative medicine use is prominent in the United States. The use of complementary and alternative therapies appears to be common in patients with inflammatory bowel disease, but few studies have been completed in children. We sought to examine the extent that children with inflammatory bowel disease in the Greater Philadelphia area (Philadelphia County and the surrounding counties in Delaware, New Jersey, and Pennsylvania) use alternative therapies. We paid particular attention to the specific types of therapies used and whether certain demographic and disease associated factors influence the degree of usage. In this study, we questioned the families of all children diagnosed with inflammatory bowel disease, aged 6 to 16 years and living within Philadelphia and its surrounding counties, who were followed at 1 of the 2 academic pediatric gastroenterology programs that served the area. More than 80% of surveys were returned. Fifty-one percent (95% C.I. 45% to 56%) of patients surveyed reported some form of alternative medicine use within the previous year. Univariate analysis revealed increased use among patients who had Crohn disease, who used the Internet for research on their disease, who reported poor quality of life and had increased school absences in the past year. Therapies associated with alternative medicine use included biological and immunomodulatory therapy. Regression analysis revealed positive associations between use of alternative therapies and expenditure on nonprescription treatments, poor quality of life, Internet research, and the need for calorie supplementation, whereas there was a negative association with history of prior surgery for inflammatory bowel disease.

Adolescent↗
PubMed2004

Comparative cardiac safety of low-dose thioridazine and low-dose haloperidol.

AIM: To compare the rate of ventricular arrhythmia, sudden death and unexplained or unattended death among users of thioridazine and haloperidol. METHODS: Observational cohort study of thioridazine and haloperidol users in the UK General Practice Research Database (GPRD) using data from 1987 through 29 June 2000. Patients were followed for 30 days following each study prescription. The event of interest was a diagnosis of ventricular arrhythmia, sudden death, or unexplained or unattended death. Cox regression was used to calculate rate ratios (RRs) and 95% confidence intervals (CIs), to examine potential confounding factors, and to examine dose-response relationships. RESULTS: Use of thioridazine and haloperidol in the GPRD was primarily in older patients, at low dose (median daily dose 31 mg thioridazine, 1.8 mg haloperidol). There was no association between thioridazine use and the rate of ventricular arrhythmia, sudden death, and unexplained or unattended death (adjusted RR 0.9, 95% CI 0.7, 1.1). The rate did not appear to increase with dose for either drug over the range observed. CONCLUSIONS: These results suggest that low-dose thioridazine and haloperidol have similar cardiac safety.

Adolescent↗
PubMed2004

Alcohol exposure and breast cancer: results of the women's contraceptive and reproductive experiences study.

OBJECTIVES: To explore associated biological outcomes and clarify the role of timing of exposure in the alcohol-breast cancer relationship. METHODS: In a population-based study of 4,575 women ages 35 to 64 years diagnosed with invasive breast cancer between 1994 and 1998 and 4,682 controls, we collected details of lifetime alcohol use and factors that could confound or modify the alcohol-breast cancer relationship. We used conditional logistic regression to compute the odds of breast cancer among drinkers relative to nondrinkers at all ages and at ages 35 to 49 and 50 to 64 years separately. RESULTS: Recent consumption (at reference age minus two) of >/=7 drinks per week was associated with increased risk [odds ratio (OR), 1.2; 95% CI, 1.01-1.3] and evidence of dose response was observed. Most of the excess was observed among women ages 50-64 years (OR 1.3; 95% CI, 1.1-1.6), although the test for age interaction was not statistically significant. Exposure later in life seemed more important than early exposure. Excess breast cancer associated with recent consumption was restricted to localized disease. When outcome was examined according to tumor hormone receptor status, highest risks were observed for estrogen receptor-positive/progesterone receptor-negative tumors (OR 1.6; 95% CI, 1.2-2.3). CONCLUSIONS: The effect of timing of alcohol exposure on breast cancer risk is complicated and will require additional study focused on this one issue. Further work is needed to explain how alcohol exposure, sex hormones, and tumor receptor status interact.

Adult↗