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Biomedical subjects

D Colin

Publications and source records attributed to D Colin.

At least 19 recordsLinked to original sources
PubMed2006

Carcinoma of the cervix and tobacco smoking: collaborative reanalysis of individual data on 13,541 women with carcinoma of the cervix and 23,017 women without carcinoma of the cervix from 23 epidemiological studies.

Tobacco smoking has been classified as a cause of cervical cancer, but the effect of different patterns of smoking on risk is unclear. The International Collaboration of Epidemiological Studies of Cervical Cancer has brought together and combined individual data on 13,541 women with and 23,017 women without cervical carcinoma, from 23 epidemiological studies. Relative risks (RRs) and 95% confidence intervals (CIs) of carcinoma of the cervix in relation to tobacco smoking were calculated with stratification by study, age, sexual partners, age at first intercourse, oral contraceptive use and parity. Current smokers had a significantly increased risk of squamous cell carcinoma of the cervix compared to never smokers (RR = 1.60 (95% CI: 1.48-1.73), p<0.001). There was increased risk for past smokers also, though to a lesser extent (RR = 1.12 (1.01-1.25)), and there was no clear trend with time since stopping smoking (p-trend = 0.6). There was no association between smoking and adenocarcinoma of the cervix (RR = 0.89 (0.74-1.06) and 0.89 (0.72-1.10) for current and past smokers respectively), and the differences between the RRs for smoking and squamous cell and adenocarcinoma were statistically significant (current smoking p<0.001 and past smoking p = 0.01). In current smokers, the RR of squamous cell carcinoma increased with increasing number of cigarettes smoked per day and also with younger age at starting smoking (p<0.001 for each trend), but not with duration of smoking (p-trend = 0.3). Eight of the studies had tested women for cervical HPV-DNA, and in analyses restricted to women who tested positive, there was a significantly increased risk in current compared to never smokers for squamous cell carcinoma (RR = 1.95 (1.43-2.65)), but not for adenocarcinoma (RR = 1.06 (0.14-7.96)). In summary, smokers are at an increased risk of squamous cell but not of adenocarcinoma of the cervix. The risk of squamous cell carcinoma increases in current smokers with the number of cigarettes smoked per day and with younger age at starting smoking.

Adult↗
PubMed2006

[Chronic instability in the ankle area].

For ankle sprains, the initial radiological work-up must include weight-bearing AP and lateral stress views of the sprained and healthy ankle. Films are taken in auto-varus. Other explorations included arthroMRI, arthroscanner or MRI which can be indicated preoperatively to confirm suspected cartilage injury or an associated ligament tear. These techniques should be employed when pertinent information can be expected according to the clinical situation and the operator's experience. In the emergency setting, ultrasonography can provide a simple low-cost confirmation of joint hematoma which is more precise than x-rays with a positive predictive value of nearly 100%. The objective and subjective clinical outcome after surgical anatomic repair or ligamentoplasty are quite similar. The two principal differences relate to persistent subjective instability and post-operative surgical complications. Thus there are advantages and disadvantages for each option advantage for anatomical repair because of the low rate of surgical complications and advantage for ligament repairs which stabilize the subtalar joint with a low rate of residual instability.

Ankle↗
PubMed2005

Second primary cancers among 109 000 cases of non-Hodgkin's lymphoma.

An analysis of other primary cancers in individuals with non-Hodgkin's lymphoma (NHL) can help to elucidate this cancer aetiology. In all, 109 451 first primary NHL were included in a pooled analysis of 13 cancer registries. The observed numbers of second cancers were compared to the expected numbers derived from the age-, sex-, calendar period- and registry-specific incidence rates. We also calculated the standardised incidence ratios for NHL as a second primary after other cancers. There was a 47% (95% confidence interval 43-51%) overall increase in the risk of a primary cancer after NHL. A strongly significant (P<0.001) increase was observed for cancers of the lip, tongue, oropharynx*, stomach, small intestine, colon*, liver, nasal cavity*, lung, soft tissues*, skin melanoma*, nonmelanoma skin*, bladder*, kidney*, thyroid*, Hodgkin's lymphoma*, lymphoid leukaemia* and myeloid leukaemia. Non-Hodgkin's lymphoma as a second primary was increased after cancers marked with an asterisk. Patterns of risk indicate a treatment effect for lung, bladder, stomach, Hodgkin's lymphoma and myeloid leukaemia. Common risk factors may be involved for cancers of the lung, bladder, nasal cavity and for soft tissues, such as pesticides. Bidirectional effects for several cancer sites of potential viral origin argue strongly for a role for immune suppression in NHL.

Aged↗
PubMed2005

Mortality in New Zealand workers exposed to phenoxy herbicides and dioxins.

AIMS: To evaluate mortality in New Zealand phenoxy herbicide producers and sprayers exposed to dioxins. METHODS: Phenoxy herbicide producers (n = 1025) and sprayers (n = 703) were followed up from 1 January 1969 and 1 January 1973 respectively to 31 December 2000. A total of 813 producers and 699 sprayers were classified as exposed to dioxin and phenoxy herbicides. Standardised mortality ratios (SMR) were calculated using national mortality rates. RESULTS: At the end of follow up, 164 producers and 91 sprayers had died. Cancer mortality was reduced for sprayers (SMR = 0.82, 95% CI 0.57 to 1.14) and increased in exposed production workers (SMR = 1.24, 95% CI 0.90 to 1.67), especially for synthesis workers (SMR = 1.69), formulation and lab workers (SMR = 1.64), and maintenance/waste treatment/cleaning workers (SMR = 1.46). Lymphohaematopoietic cancer mortality was increased in exposed production workers (SMR = 1.65, 95% CI 0.53 to 3.85), especially for multiple myeloma (SMR = 5.51, 95% CI 1.14 to 16.1). Among sprayers, colon cancer (SMR = 1.94, 95% CI 0.84 to 3.83) showed increased mortality. CONCLUSIONS: Results showed 24% non-significant excess cancer mortality in phenoxy herbicide producers, with a significant excess for multiple myeloma. Associations were stronger for those exposed to multiple agents including dioxin during production. Overall cancer mortality was not increased for producers and sprayers mainly handling final technical products, although they were likely to have been exposed to TCDD levels far higher than those currently in the general New Zealand population.

Agricultural Workers' Diseases↗
PubMed2005

Preventing the occurrence of pressure ulceration in hospitalised elderly patients.

OBJECTIVE: To determine which factors contribute to the development of pressure ulcers and to evaluate the role of topical agents in preventing their occurrence. METHOD: An observational, prospective survey covered 36 care of the elderly wards and involved 1121 patients at high or very high risk of pressure ulceration. The patients, of whom 667 (59.6%) received a gentle application of a topical agent to at-risk areas, were followed up for eight weeks. RESULTS: Of the patients, 15.7% developed a pressure ulcer. The use of a corpitolinol 60-based topical agent (Sanyrène/Corpitol) significantly reduced the incidence of pelvic pressure ulcers (p=0.04) when used with recognised prevention strategies. This was identified by undertaking a logistic regression analysis. The resulting odds ratio of 0.61 indicates that the intervention helped to reduce the number of pressure ulcers by 40%. CONCLUSION: The results of this observational study can provide a useful guide to the design of further randomised controlled trials.

Activities of Daily Living↗
PubMed2004

[Prospective study of the outcome at one year of patients with chronic low back pain in a program of intensive functional restoration and ergonomic intervention. Factors predicting their return to work].

OBJECTIVES: Evaluation of 1-year outcome after patients with chronic low back pain participated in an intensive functional restoration program associated with an ergonomic intervention on the workplace. Study of the factors predicts a return to work. METHODS: Prospective study of a cohort of 87 patients face major difficulties due to low back pain at work. Patients who visited a multidisciplinary clinic were included. Parameters, evaluating physical and psychological status, quality of life, presence at work, length of sick leaves, were determined before and after the program and at 6 and 12 months' followup. The correlation between these parameters and presence at work at 1 year was studied. RESULTS: A total of 86 patients completed the program; three were lost to followup at 1 year. Ergonomic interventions were tried in 53 patients. All parameters were improved at the end of the program and remained significantly improved at 12 months. A total of 90% of the patients returned to work at the end of the program, whereas only 17% were at work before; 72% were at work in 1 year. The number of sick leave days decreased by 60%. The Dallas index at the beginning and the end of the program, the number of sick leave days before the program and score on the item "feels able to work" correlated with the presence at work in 1 year. There was no correlation between presence at work and physical parameters. CONCLUSION: This study shows the effect of the program and determines factors predictive of successful return to work for patients with chronic low back pain. Further data are necessary to discuss the specific effect of ergonomic interventions.

Absenteeism↗
PubMed2001

The use of MR images to evaluate the risks associated with proximal locking of intramedullary tibial nails.

Vascular complications associated with locked intramedullary tibial nailing are infrequent but always serious, with a secondary amputation rate of 30%. These complications, based on an MR study of the anatomic relationships between the interlocking screws and the neurovascular or articular structures at the proximal end of the tibia, have been analysed. Two types of nails were used: one with anterior-posterior locking and a specially designed prototype with oblique locking. In particular this study emphasised the anatomic risk of injury to the popliteal structures when using anterior-posterior locking, as well as to the anterior tibial vessels and proximal tibiofibular joint when using oblique locking. As no locking method appears to be better than any other, the best is that associated with the lowest morbidity. Consequently, the use of frontal instead of anterior-posterior locking is recommended; the use of oblique locking, which this study has shown carries a much higher risk of complications, is strongly advised against.

Bone Nails↗
PubMed2001

Update of the follow-up of mortality and cancer incidence among European workers employed in the vinyl chloride industry.

Although vinyl chloride is an established cause of liver angiosarcoma, the evidence is inconclusive on whether it also causes other neoplastic and nonneoplastic chronic liver diseases as well as neoplasms in other organs. Furthermore, the shape of the dose-response relation for angiosarcoma is uncertain. We have extended for approximately 8 years the mortality and cancer incidence follow-up of 12,700 male workers in the vinyl chloride industry in four European countries. All-cause mortality was lower than expected, whereas cancer mortality was close to expected. A total of 53 deaths from primary liver cancer (standardized mortality ratio 2.40, 95% confidence interval = 1.80-3.14) and 18 incident cases of liver cancer were identified, including 37 angiosarcomas, 10 hepatocellular carcinomas, and 24 liver cancers of other and unknown histology. In Poisson regression analyses we observed a marked exposure response for all liver cancers, angiosarcoma, and hepatocellular carcinoma. The exposure-response trend estimated for liver cancer in analyses restricted to cohort members with cumulative exposures of <1,500 parts per million-years was close to that estimated for the full cohort (relative risk of 2.0 per logarithmic unit of cumulative dose). No strong relation was observed between cumulative vinyl chloride exposure and other cancers. Although cirrhosis mortality was decreased overall, there was a trend with cumulative exposure.

Carcinogens↗
PubMed2000

Second primary neoplasms following non-Hodgkin's lymphoma in New South Wales, Australia.

The incidence of non-Hodgkin's lymphoma (NHL) has been increasing rapidly over the last three decades. The reasons for this trend are not known although increasing exposure to sunlight has been postulated. We used data from the New South Wales Central Cancer Registry to analyse second primary neoplasms following NHL diagnosed between 1972 and 1995, to identify possible common causal agents. A total of 12,452 patients contributed 54,308 person-years of follow-up during which time there were 705 second primary neoplasms compared to 592.99 expected (standardized incidence ratio (SIR = 1.19, 95% confidence interval (CI) 1.10-1.28). There were excesses of melanomas of skin (SIR = 2.38, 95% CI 1.92-2.91), lip cancer (SIR = 2.74, 95% CI 1.59-4.38), tongue cancer (SIR = 2.53, 95% CI 1.09-4.99) and bladder cancer (SIR = 1.64, 95% CI 1.19-2.21). There was also over a threefold excess in soft tissue sarcomas (SIR = 3.61, 95% CI 1.80-6.45) and in thyroid cancer (SIR = 3.42, 95% CI 1.56-6.49). The SIR for myeloid leukaemia was 0.78 (95% CI 0.28-1.69). The increases in melanoma of the skin and cancer of the lip and tongue among patients with NHL strongly suggest sunlight exposure as a shared causal agent. The increase in soft tissue sarcomas might be due to shared effects of exposure to chemicals such as phenoxy acid herbicides. The increases in bladder and thyroid cancers are likely to be explained by effects of treatment for NHL. We did not find a chemotherapy related increased risk of myeloid leukaemia among NHL patients.

Adult↗
PubMed2000

Mortality from cancer and chronic respiratory diseases among workers who manufacture carbon electrodes.

OBJECTIVES: To investigate the risk of cancer and non-neoplastic respiratory diseases among workers who manufacture carbon electrodes, as this industry entails exposure to mixtures of polycyclic aromatic hydrocarbons. METHODS: A historical cohort study was carried out of 1006 male workers employed for at least 1 year between 1945 and 1971 in a carbon (graphite) electrode production plant in central Italy, who were followed up for mortality between 1955 and 1996. The ratio of observed to expected deaths (standardised mortality ratios, SMRs) was computed from both national and (for the period 1964-96) regional age and period specific mortalities. A multivariate Poisson regression analysis was performed to investigate the relative risk (RR) of death according to duration of employment and time since first employment in the factory. RESULTS: A total of 424 workers had died, 538 were still alive, and 44 were lost to follow up. Mortalities from all causes, all cancers, and respiratory tract cancer were in line with the regional figure. An excess was found over the expected deaths from skin cancer including melanoma (SMR 3.16, 95% confidence interval (95% CI) 0.65 to 9.23) and from non-neoplastic respiratory diseases (SMR 1.58, 95% CI 1.16 to 2.11). Poisson regression analysis including age as a covariate showed an increased risk of dying from gastric cancer with increasing duration of employment, and an increase in the RR of dying from lung cancer and from non-neoplastic respiratory diseases with increasing time since first employment, although the linear trend was not significant. CONCLUSION: This study supports previous findings that working in the carbon electrode manufacturing industry may not increase the risk of dying from respiratory cancer. However, a possible association with non-malignant respiratory diseases cannot be excluded.

Adult↗
PubMed1999

Cancer incidence and mortality in a cohort of chloroprene workers from Armenia.

We evaluated the risk of cancer among 1897 men and 417 women exposed to chloroprene (2-chloro-1,3-butadiene, CP) at a production plant in Yerevan, Armenia, between 1940 and 1988. The cohort was followed up for cancer incidence for the years 1979-1990 and for cancer mortality for 1979-1988. In the cohort, incidence and mortality from all cancers were below expectation, but increased incidence (standardized incidence ratio 3.27, 95% confidence interval [CI] 1.47-7.27), and mortality (standardized mortality ratio 3.39, 95% CI 1.09-10.5) from liver cancer were noticed. A dose-response relationship was suggested between liver cancer and indices of CP exposure, such as duration of employment, duration of high CP exposure and cumulative exposure to CP. The risk of other neoplasms was not increased.

Armenia↗
PubMed1999

Determination of age at death: assessment of an algorithm of age prediction using numerical three-dimensional CT data from pubic bones.

The determination of age at death is an important part of physical and forensic anthropology. Because of resistance to decomposition and the simplicity/accuracy ratio, the direct observation of the os pubis by Suchey-Brooks phase analysis is the preferred reference system for determination of age at death. We propose an age-prediction system using a pubic symphysis numerical database obtained from CT x-ray through quantification of age-linked parameters. Our system increases the accuracy of age estimation and at the same time preserves the integrity of the archeological material.

Adult↗
PubMed1999

[Perineural fibrosis of the median nerve at the wrist. Treatment by neurolysis and dermal-hypodermal graft].

UNLABELLED: In the treatment of multiple recurrences of carpal tunnel syndrome due to fibrosis, following repeated nerve release, the authors propose interposition of a composite dermal fat graft raised from the inguinal region, and report four clinical cases using this technique. The objective of this study was to evaluate the efficacy of the graft in terms of clinical and electromyographic results and determine the course of the graft by a postoperative MRI study and a longer follow-up. CLINICAL RESULTS: Nocturnal paraesthesiae resolved in 2 patients, was improved in one patient and remained unchanged in another patient. Objectively, neurological examination showed improvement in 3 cases and no change in 1 case. Electromyographic results: At last follow-up, EMG was improved in only one case. Magnetic resonance imaging: MRI visualized the graft with a fat signal on T1-weighted sequences in every case, with an increase in size over time in 3 cases. The efficacy of the dermal fat graft may seem disappointing, as none of the patients were cured. However, with a mean follow-up of more than two years, we have not observed any deterioration of the clinical features, and no surgical revision for carpal tunnel syndrome. This technique appears to increase graft survival, as the blood supply to the subdermis is restored more rapidly via the dermis, which is anatomically a very vascular tissue. There is nevertheless a discrepancy between the clinical results, and EMG and MRI findings, which could be explained by the anatomical lesion of the median nerve, surgically released several times, and by alterations of the perineurium.

Adipose Tissue↗