Biomedical subjects

Brian L Strom

Publications and source records attributed to Brian L Strom.

93 records · Page 6Linked to original sources

PubMedDate not supplied

Estrogen replacement therapy and risk of lung cancer.

PURPOSE: Some epidemiological data suggest that sex hormones may influence lung cancer risk, and estrogen receptors have been found in human non-small cell lung tumors. We assessed the relation of the use of estrogen replacement therapy (ERT) to the risk of lung cancer in our hospital-based Case-Control Surveillance Study, conducted in four US centers during 1976 to 2001. METHODS: Cases were 662 women aged 40 through 74 years with lung cancer and controls were 4671 women admitted for conditions unrelated to ERT use. We used multivariate unconditional logistic regression models to estimate odds ratios (OR) and 95% confidence intervals (CI) for ERT use for at least 3 months compared to no use or use for less than 3 months. RESULTS: The OR for lung cancer among ERT users was 1.0 (95%CI 0.8-1.4), and it was 1.0 (95%CI 0.7-1.4) among users of conjugated estrogens only. Risk did not increase as the duration of use increased. Odds ratios for specific lung cancer cell types were not significantly increased or decreased for use of ERT or conjugated estrogens. There were non-significant increases for non-small cell types other than squamous, but there was no consistent pattern across duration of use. CONCLUSION: Our data do not support an increased risk of lung cancer among women who use ERT.

Adult↗

PubMedDate not supplied

Agreement between patient self-report and a Veterans Affairs national pharmacy database for identifying recent exposures to antibiotics.

PURPOSE: The dramatic rise in antibiotic drug resistance among community pathogens has stimulated interest in the epidemiological relationship between antibiotic exposure and drug resistance. In assessing the strength of this relationship, studies are hampered by the lack of data on the accuracy of subject self-report of antibiotic exposure. The authors compared self-report with pharmacy dispensing data to determine the accuracy of self-reported antibiotic exposure. METHODS: The study design was a cross-sectional survey of veterans seen at the Philadelphia Veterans Affairs (VA) Medical Center in 1999 and 2000. Subjects reported exposures to antibiotics, antihypertensive drugs and nonsteroidal anti-inflammatory drugs through a structured telephone interview. The instrument included open-ended questions, condition-specific prompts and drug-specific prompts. Subject responses were linked to a national VA pharmacy database that served as the reference standard for evaluating self-reported exposures. RESULTS: The authors found that the sensitivity of self-report of antibiotic exposure increased with increasing use of prompts. A comprehensive assessment of antibiotic exposure identified 73% of antibiotic exposures, compared to 73% of antihypertensive drug exposures and 92% of nonsteroidal anti-inflammatory drug exposures. CONCLUSIONS: Assessment of antibiotic exposure appears to be comparable to assessment of other chronic and episodic drugs. Multistep assessment of exposure improves the sensitivity of assessment.

Adolescent↗

PubMedDate not supplied

Risk factors for pressure ulcers among elderly hip fracture patients.

The purpose of this study was to estimate the incidence of hospital-acquired pressure ulcers among elderly patients hospitalized for hip fracture surgery and to identify extrinsic factors that are associated with increased risk. We conducted a secondary analysis of data abstracted from medical records at 20 hospitals in Pennsylvania, Texas, New Jersey, and Virginia. Participants were patients aged 60 years and older admitted with hip fracture to the study hospitals between 1983 and 1993. The incidence of hospital-acquired pressure ulcers was 8.8% (95% confidence interval 8.2%-9.4%). After adjusting for confounding variables, longer wait before surgery, intensive care unit stay, longer surgical procedure, and general anesthesia were significantly associated with higher pressure ulcer risk. Extrinsic factors may be important markers for high pressure ulcer risk in hospitalized hip fracture patients. Although it is not possible to eliminate factors such as requiring an intensive care unit stay or having a long surgical procedure, it may be possible to develop interventions that minimize pressure ulcer risk in patients who experience these factors.

Aged↗