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E Weiderpass

Publications and source records attributed to E Weiderpass.

70 records · Page 4Linked to original sources
PubMed1998

Cisplatin-DNA adducts and protein-bound platinum in blood of testicular cancer patients.

DNA adducts formed by cisplatin [cis-diamminedichloroplatinum(II)] were measured in blood samples from 48 testicular cancer patients treated in four centers in Europe during four to six cycles with cisplatin infusions on five successive days (total samples, 112). Total protein-bound platinum (Pt) in blood was also measured (total samples, 84). The mean on the main DNA adduct, cis-Pt(NH3)2d(pGpG) (Pt-GG), was 0.75 fmol/microg DNA [standard deviation (SD) = 0.66] on the first day of the first cycle, increased after the infusion at day 5 of the cycle (mean 1.74 fmol/microg DNA, SD = 0.90) and decreased on the following day (mean 1.09 fmol/microg DNA, SD = 0.62). In subsequent cycles, there was a tendency to an increase in the mean Pt-GG levels. The values of protein-bound Pt in blood showed little reduction between day 5 and 6 of each cycle, and a stable increase during the course of the therapy. Strong correlations were seen between day 1, 5 and 6 of the first cycle for both Pt-GG and protein-bound Pt in blood. A strong correlation (r = 0.62, p < 0.001, 69 pairs) was found between the levels of Pt-GG and protein-bound Pt. Only two patients relapsed during the follow-up; therefore, the analysis of the association between Pt-GG levels and response to therapy was not informative. The results of this study suggest that DNA adducts formed by cisplatin at the beginning of chemotherapy are predictive of values found during later days and cycles, and that the value of protein-bound Pt in blood is predictive of the value of DNA adducts.

Adult↗
PubMed1998

[Incidence and duration of breast-feeding by type of delivery: a longitudinal study in southeastern of Brazil].

OBJECTIVE: To compare the incidence of breastfeeding according to type of delivery. METHODOLOGY: Population-based cohort study of 655 children born in 1993 and followed up during the first three months of life through home visits. RESULTS: Breastfeeding duration was similar among babies born either by vaginal delivery or by emergency cesarean section. Babies born by elective cesarean section, however, presented a three times higher risk of stopping breastfeeding in the first month of life, after adjusting for possible confounding factors (odds ratio = 3.09; 95% CI 1.3-7.2). The increased risk did not persist into the third month of life. CONCLUSIONS: It is recommended that health services pay special attention, in the promotion of breastfeeding, to babies born by elective cesarean section, as a way to avoid early weaning.

Adult↗
PubMed1998

[Epidemiology of drug use during the first three months of life in a urban area of southern Brazil].

INTRODUCTION: The few studies on the use of medicines in children point to excessive use, and in these studies, physicians are those mainly responsible for the prescription of medicines. In order to get to know the patterns of consumption medicines better, a study was made in children in their first three months of life, according to social biological, food pattern and use of health services of variables. METHOD: The patterns of the use of medicines during the first three months of life in 655 urban children born in Pelotas, Brazil, in 1993, were described. Information on the use of medicines was collected during a two-week period in the first and third month of life. RESULTS: The use of medicines was reported by 65% of mothers at the 1st and 69% at the 3rd month of life. Seventeen per cent of children consumed three or more different medicines during those periods. Fixed combinations of three or more components-which was taken as an indicator of the poor of medicines quality-were consumed by 14% of the children at the 1st and 19% at the 3rd months of life. At the latter age, 20% of children had used a given medicine for one month or more. At the first month follow-up, Benzalkonium Chloride + Normal Saline Solution (nasal drops), Nystatin Mixture and Dimethicone + Homotropine were the most frequently used medicines. At the third month they were, Aspirin, Benzalkonium Chloride + Normal Saline Solution and Dimethicone + Homatropine. The main reasons for taking medicines were cramps at the first month and colds at the third. At the first month follow-up, children with three or more siblings used 64% less medicines than the older ones. Children who were not breast-fed at the end of the first month showed a 75% greater risk of use of medicines. Similar results were observed at the third month follow-up. Some of the medicines used were not recommendable for children. CONCLUSION: Since early age children are submitted to an intense use of medicines for almost every conceivable reason, with the risk of potential side-effects and the possible lead to medicine or other drugs addiction.

Age Factors↗
PubMed1998

Environmental risk factors of breast cancer.

Breast cancer is women's most ubiquitous cancer. The role of dietary factors is controversial, but there is limited evidence for such occupational risk factors as employment in the pharmaceutical industry and as a beautician. Ionizing radiation probably increases the risk. Exposure to chlorinated hydrocarbon pesticides, chlorinated solvents, and polychlorinated biphenyls may be risk factors, although the evidence is insufficient. Data on low-frequency electromagnetic fields are inconclusive. Tobacco smoking may be a risk factor, but the effect may depend on N-acetyltransferase 2 genetic polymorphisms. There are yet unidentified determinants, probably environmental, that may act via estrogenic activity or through other mechanisms. The etiology may vary according to the joint estrogen and progesterone receptor status of the tumor. P53 mutation frequency varies considerably in breast cancer populations, which may reflect variation in exogenous exposures. Epidemiology research on breast cancer needs to consider subtypes of the disease, lifetime exposure assessment, host susceptibility, and adjustment for reproductive and menstrual history.

Breast Neoplasms↗
PubMed1998

Occurrence, trends and environment etiology of pancreatic cancer.

This review summarizes data on the occurrence, the trends, and the life-style, environmental, occupational and genetic determinants of pancreatic cancer. Epidemiologic evidence implicates tobacco smoking as one cause. The evidence regarding alcohol consumption is inconsistent. Although both positive and inconclusive findings are encountered, the bulk of the evidence on coffee consumption is negative. Fat intake is linked with obesity and diabetes mellitus, which are risk factors for pancreatic cancer. Fruit and vegetable consumption appears to be protective. No occupational or environmental agent has been confirmed to increase the risk, but epidemiologic evidence is inconsistent, Little is known about the role of genetic polymorphisms of metabolic enzymes in pancreas carcinogenesis. Pancreatic cancer shows high rates of mutations of Ki-ras and losses or mutations of tumor suppressor genes (p53, p16INK4A, and SMAD4/DPC-4). Ki-ras mutations have been associated with life-style factors in relation to pancreatic cancer, but the evidence is still scant and inconsistent.

Female↗
PubMed1998

Epidemiology of occupational and environmental risk factors related to ovarian cancer.

This paper reviews articles published during 1970-1997 from 48 epidemiologic studies on occupational and environmental risk factors of ovarian cancer. Current evidence is characterized by poorly focused data for occupational and environmental agents, vulnerability to biases, and an almost complete lack of quantitative exposure-response data. The moderate amount of data on nurses, teachers, professionals, dry cleaning employees, women in agriculture, the pharmaceutical industry, pharmacists, waitresses, and cooks show very little, if any, evidence of excess risk. Hairdressers, beauticians, and women employed in the printing industry may be at increased risk, but the data are insufficient for strong conclusions. Some case-referent studies suggest a modest-to-moderate excess in association with genital talc application. Few high-quality studies have been carried out, and no chemical agents have been studied extensively, with the exception of exposure to talc. Ovarian cancer may have occupational and environmental etiologies intertwined with cultural, behavioral, and life-style factors and genetic susceptibility, but current knowledge is insufficient to quantify occupational and environmental etiologies reliably. Well-designed analytic epidemiologic studies with sufficient power are needed.

Adolescent↗
PubMed1997

Risk of endometrial and breast cancer in patients with diabetes mellitus.

Diabetes mellitus patients have metabolic and endocrine alterations that could contribute to an increased incidence of hormone-related cancers. We assessed the incidence of endometrial and breast cancer among 80,005 women and the incidence of breast cancer among 73,847 men (total of 153,852 patients) identified in the Swedish In-patient Register as having been hospitalized for diabetes mellitus in the period 1965-1983. These patients underwent follow-up through 1989 via the Swedish Cancer Register and other nation-wide Swedish registers. The outcome measures were standardized incidence ratios (SIR) based on age-, sex- and calendar period-specific incidence rates from the entire Swedish population. To minimise the effect of selection bias, we excluded from the calculation of incidence ratios the first year of observation and cases diagnosed incidentally at autopsy. Only first cancers were considered for the estimates. A total of 328 endometrial cancers (SIR = 1.8; 95% confidence interval [CI] = 1.6-2.0), 1,145 female breast cancers (SIR = 1.3; 95% CI = 1.2-1.4) and 13 male breast cancers (SIR = 2.0; 95% CI = 1.0-3.4) were observed. We conclude that compared with the general population, patients with diabetes mellitus have an increased incidence of endometrial and breast cancers.

Adult↗
PubMed1997

Risk for endometrial cancer following breast cancer: a prospective study in Sweden.

The risk for endometrial cancer among women with breast cancer might increase following use of tamoxifen, recently classified as a carcinogen of the human endometrium. However, the strength of the association remains uncertain and it is unknown whether use of this drug--widely prescribed in Sweden since the mid-1980s--has had any measurable effect at the population level. We analyzed all cases of breast cancer (n = 131,614) detected in the nationwide Swedish Cancer Registry in 1958-93. Incident cases of endometrial cancer during follow-up were identified also through the Cancer Registry. Standardized incidence ratios (SIR) and their 95 percent confidence intervals (CI) were computed by use of nationwide rates of endometrial cancer, adjusted for age and calendar year. During follow-up of up to 35 years of the breast cancer cohort, 803 incident endometrial cancers were identified, yielding an overall SIR of 1.58 (CI = 1.47-1.70). In univariate analyses, there was no increase in SIR in recent years. However, the excess risk increased linearly with increasing age at breast cancer diagnosis (P trend < 0.0001) and decreased markedly with longer follow-up (P trend < 0.0001). A multivariate regression analysis, with adjustment for age and year of follow-up, revealed no increased risk for subsequent endometrial cancer among breast cancer cases diagnosed more recently (P trend = 0.19); compared with the period 1958-63, the risk estimate in the last time period (1989-93) was 0.72 (CI = 0.51-1.01). We conclude that the risk for endometrial cancer following breast cancer has not increased over time in Sweden.

Adult↗
PubMed1997

Pacifier use and short breastfeeding duration: cause, consequence, or coincidence?

OBJECTIVES: Pacifiers are related to a shorter duration of breastfeeding. However, it is unclear whether this association is causal, because confounding, reverse causality, and self-selection of mothers may play a role. These issues were investigated through a combination of epidemiologic and ethnographic research in southern Brazil. METHODOLOGY: A population-based cohort of 650 mothers and infants were visited shortly after delivery and at 1, 3, and 6 months. The rate of complete follow-up was 96.8%. A subsample of 80 mothers and infants was selected for the ethnographic study, which included in-depth interviews and participant observations in the age range of 2 to 6 months with a mean of 4.5 visits. RESULTS: The epidemiologic study showed that pacifier use was common with 85% of users at 1 month. However, this was a dynamic process, with many infants starting or abandoning the pacifiers in any age range. Children who stopped breastfeeding in a given period were likely to take up the pacifier during that period. Further analyses excluded all infants not breastfed at 1 month of age and those who reportedly had breastfeeding problems, leaving 450 infants with full data. Intense pacifier users at 1 month (children who used the pacifiers during most of the day and at least until falling asleep) were four times more likely to stop breastfeeding by 6 months of age than nonusers. Users also had fewer daily breastfeedings than nonusers. After adjustment for several confounding variables, logistic regression showed that pacifier use was still associated with an odds ratio of 2.5 (95% confidence interval, 1.40 to 4.01) for stopping breastfeeding. The ethnographic analysis showed that pacifier use was widely regarded as a positive behavior and that mothers often strongly stimulated the infants to accept it. Although few mothers openly admitted that pacifiers might shorten breastfeeding, a considerable group effectively used pacifiers to get their infants off the breast or to increase the interval between feedings. The latter also had rigid breastfeeding styles that increased maternal-infant distance, had important concerns about objective aspects of infant growth and development, and were highly sensitive to infant crying. These behaviors were linked to intense comparison between themselves and other mothers and to a lack of self-confidence. Nonwhite mothers, those who delivered vaginally, and mothers of infant girls seemed to be more confident and less affected by these difficulties. The epidemiologic analysis confirmed that pacifier use was more closely associated with breastfeeding duration among nonwhite mothers and for normally delivered infants. CONCLUSIONS: Pacifiers may be an effective weaning mechanism used by mothers who have explicit or implicit difficulties in breastfeeding, but they are much less likely to affect infants whose mothers are confident about nursing. Breastfeeding promotion campaigns aimed specifically at reducing pacifier use will fail unless they also help women face the challenges of nursing and address their anxieties. The combination of epidemiologic and ethnographic methods was essential for understanding the complex relations between pacifier use and breastfeeding.

Bottle Feeding↗
PubMed1997

[Hospitalization due to pneumonia: the influence of socioeconomic and pregnancy factors in a cohort of children in Southern Brazil].

OBJECTIVE: To investigate the influence of socioeconomic and gestational factors on admission due to pneumonia in the post-neonatal period. METHODOLOGY: Cohort. Children born in the city Pelotas, Brazil, in 1993. Cases were children admitted to hospital for 24 hours or more, between the ages of 28 and 364 days, with a diagnosis of pneumonia. RESULTS: Of the 5,304 children in the cohort, 152 (2.9%) were hospitalized with pneumonia. The positive predictive value of the clinical diagnosis compared to the radiological assessment was 76%. Analysis by conditional logistic regression showed that social class and maternal schooling were strongly inversely associated with pneumonia Children of adolescent mothers were twice as likely to be admitted. The relative risk for children whose mothers were of parity three or greater was 2.8 relative to primiparae. Maternal weight gain during pregnancy of less than 10 kg was associated with a 40% increase in risk. CONCLUSION: Socioeconomic factors were important determinants of pneumonia admissions. Maternal age, parity and weight gain were also significant risk factors.

Brazil↗
PubMed1996

[Longitudinal study of the mother and child population in an urban region of southern Brazil, 1993: methodological aspects and preliminary results].

All babies born in the hospitals of the city of Pelotas, Brazil, in 1982 were studied soon after delivery and followed up prospectively during the first years of their lives. In 1993, this study was repeated with a similar methodology, with the aim of assessing eventual changes in the level of maternal and child health. All five maternity hospitals in the city were visited daily and the 5,304 babies born included in the study. They were weighed and measured, and their gestational age was assessed using the Dubowitz method. Their mothers were examined and interviewed regarding a large number of risk factors. The mortality of these children was studied through the surveillance of all hospitals, cemeteries and death registries, and all hospital admissions were also recorded. Two nested case-control studies were carried out to assess risk factors for mortality and hospital morbidity. A systematic sample of 655 children were examined at home at one and three months of age, and these infants, as well as another sample of 805 children including all low-birthweight babies were also examined at the ages of six and twelve months. Their psychomotor development was also assessed. Losses to follow-up were only 6.6% at twelve months. Relative to the 1982 indicators, perinatal mortality fell by about 30% and infant mortality by almost 50%. The median duration of breastfeeding increased from 3.1 to 4.0 months. On the other hand, there was little change in the prevalences of low birthweight or of length for age at twelve months. The article that refers this abstract describes the methodology of the study and forthcoming publications will present detailed results.

Birth Weight↗
PubMed1995

Use of pacifiers is associated with decreased breast-feeding duration.

OBJECTIVE: To determine the relationship between pacifier use at 1 month of age to the duration of breast-feeding to 6 months of age. DESIGN: Longitudinal study of infants from birth to 6 months of age. POPULATION: Six hundred five rooming-in infants born at the largest hospital in Guarujá, São Paulo, Brazil, during January and February 1993. MAIN OUTCOME MEASURES: Prevalence of breast-feeding (exclusive, predominant, and complementary) at 1, 4, and 6 months of age. RESULTS: Relative risk for weaning between 1 and 6 months of age was 3.84 (95% confidence interval 2.65-5.50) for pacifier users at 1 month of age, compared with nonusers. When an adjustment was made for possible confounding variables through Cox regression analysis, the relative risk dropped to 2.87 (95% confidence interval 1.97-419). CONCLUSION: Pacifier use is highly correlated with early weaning, even after controlling for possible confounders. Until it is determined if pacifier use is causally related to weaning or is a marker for other undetermined causes, pacifier use probably should not be recommended for breast-fed infants.

Breast Feeding↗
PubMed1991

[The worker model and perception of occupational and environmental risks: the optimal use of a descriptive study].

An attempt was made to identify the risks resulting from exposure to the chemicals to which workers are exposed as well as from the poor working conditions to which they are subject in a chemical and pharmaceutical factory. A descriptive study based on the "workers model"--a methodological approach developed in Italy in the 60's, was carried out. Such a study requires direct contact with the workers and has the advantage of overcoming the difficulty of gaining access to their work-place. The activities of the different departments of the plant were reconstructed and the main chemicals used, the main physical complaints, the potential harms and the main environmental risks identified. The report on the harmful working conditions produced was used by the workers as a means of pressing the authorities into carrying out an inspection of the plant concerned to verify its accuracy. The report's findings have been confirmed and demonstrate the usefulness of the methodological approach adopted. The workers' publicizing of the study's findings through the means of mass communication have helped to build up greater public awareness of the occupational and environmental risks of that particular industrial activity.

Chemical Industry↗
PubMedDate not supplied

[Benzodiazepines: prescription study in a primary health care unit].

PURPOSE: The objective of this survey was to study the prescription rate of benzodiazepinics in a Primary Health Care Unit, in the city of Pelotas, RS, Brazil. METHOD: Every consultation during a 12 month period was recorded, including the prescription of drugs. In order to analyze the prescription of benzodiazepinics we considered only the 3,368 consultations of patients above 25 years. RESULTS: Patients whose age ranged from 45-64 years experienced the highest prescription rates, benzodiazepinics being the third most prescribed drug for males and the fourth for females. CONCLUSION: The results show that benzodiazepinics are among the most prescribed drugs.

Adult↗