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E White

Publications and source records attributed to E White.

At least 181 records · Page 10Linked to original sources
PubMed1995

A case-control study to evaluate efficacy of screening for faecal occult blood.

OBJECTIVES: Faecal occult blood testing is routinely used for early detection of colorectal cancer, but evidence of its efficacy in preventing death from colorectal cancer is limited. A case-control study was carried out to evaluate whether screening for faecal occult blood is associated with a reduced risk of fatal colorectal cancer. SETTING: A health maintenance organisation in western Washington State, which has offered its members faecal occult blood testing every two years since 1983. METHODS: Cases (n = 248) were members of the health maintenance organisation who died from colorectal cancer between 1986 and 1991. For each case, two control subjects, who did not die from colorectal cancer and who were similar to each case in age, gender, and year of enrollment at the health maintenance organisation, were randomly selected from the membership list of the year in which the case was diagnosed (n = 496). Information about episodes of faecal occult blood testing (including the location and reason for the test, and the evaluation of positive tests) and potential confounders was obtained from medical records. RESULTS: Cases were less likely than controls to have ever been screened (odds ratio (OR) = 0.7, 95% confidence interval (CI) 0.5 to 1.0), consistent with a beneficial impact of screening. There was little difference, however, for screening that had taken place within a three year period before diagnosis (OR = 0.9, 95% CI 0.6 to 1.2), the maximum interval during which most tumours ought to have been detectable by faecal occult blood testing. A reduction in risk was seen for home testing but not for office testing, and in individuals aged less than 75 but not in those aged 75 or older. Although most of the 21 controls with a positive faecal occult blood test underwent some additional testing, only five (24%) were evaluated with colonoscopy or air contrast barium enema. CONCLUSIONS: While there can be uncertainty as to whether specific faecal occult blood tests were performed as screening or diagnostic tests, those performed at home and in younger persons may be relatively less likely to be diagnostic tests that were misclassified as screening. Thus the modest reduced risk associated with faecal occult blood testing in these settings/persons may reflect genuine benefit. However, the presence of a reduced risk associated with a screening faecal occult blood test received in the past, well before a tumour or polyp might bleed enough to allow detection, is compatible with uncontrolled confounding. Interpretation is further complicated by the fact that a number of individuals in the study group who had positive test results underwent limited or no diagnostic testing. Thus our results should be interpreted with considerable caution.

Age Factors↗
PubMed1995

Growth screening and urban deprivation.

OBJECTIVES: To assess the effect of urban deprivation on childhood growth in a modern British society by analysing data from a regional growth survey, the Tayside growth study. SETTING: The Tayside Region in Scotland, which has three districts with distinct socioeconomic status: Dundee (D, urban city), Angus (A, rural), and Perth (P, rural and county town). SUBJECTS AND METHODS: Height and weight of 23,046 children (> 90% of the regional childhood population) were measured as part of a child health surveillance programme, by community health care workers at 3, 5, 7, 9, 11, and 14 years. Height standard deviation score (calculated against Tanner) and body mass index (BMI-weight (kg)/height (m)2) were calculated for each child by a central computer program; mean height standard deviation score and BMI standard deviation score were calculated for each measuring centre (school, health clinic). A deprivation score for each centre was calculated from the prevalence of single parent families; families with more than three children; unemployment rate; the number of social class V individuals; the percentage of council houses. RESULTS: Mean height standard deviation score for Tayside was 0.11. An intraregional difference was demonstrated: mean height standard deviation score (SD) D = 0.04 (1.0); A = 0.14 (1.1); P = 0.21 (1.1); P < 0.002. There was a positive association between short stature and increasing social deprivation seen throughout Tayside (P < 0.05), with a strong association in Dundee primary school children (r = 0.6; P < 0.001). Analysis by district showed that the association was significant only above the age of 8 (P < 0.004). There was no relation between BMI and social deprivation. CONCLUSIONS: In an industrialised developed society, urban deprivation appears to influence height mostly in late childhood, and this association should be taken into consideration in the clinical management of short stature. Height seems to be a better physical indicator of urban deprivation, and hence an index of childhood health, than BMI.

Adolescent↗
PubMed1995

Physician recommendations for dietary change: their prevalence and impact in a population-based sample.

A random-digit-dialing survey to examine the prevalence, content, and impact of physician dietary recommendations in a representative population-based sample of Washington State residents was administered to 1972 persons aged 18 years and older. Twenty percent of those surveyed received a physician's recommendation for dietary change in the previous year. The most common recommendations were to decrease intake of cholesterol, calories, and red meat and to increase intake of vegetables and fiber. Respondents receiving recommendations were more likely to report decreased use of high-fat foods and increased use of high-fiber foods and to be in the maintenance stage of dietary change. Results suggest that physicians can play a limited role in promoting dietary change.

Adolescent↗
PubMed1995

Psychopathology of catatonic speech disorders and the dilemma of catatonia: a selective review.

OBJECTIVE: Over the past decade there has been an upsurge of interest in the prevalence, nosological position, treatment response and pathophysiology of catatonia. However, the psychopathology of catatonia has received only scant attention. Once the hallmark of catatonia, speech disorders--particularly logorrhoea, verbigeration and echolalia--seem to have been neglected in modern literature. The aims of the present paper are to outline the conceptual history of catatonic speech disorders and to follow their development in contemporary clinical research. METHOD: The English-language psychiatric literature for the last 60 years on logorrhoea, verbigeration and echolalia was searched through Medline and cross-referencing. Kahlbaum, Wernicke, Jaspers, Kraepelin, Bleuler, Kleist and Leonhard's oft cited classical texts supplemented the search. RESULTS: In contrast to classical psychopathological sources, very few recent papers were found on catatonic speech disorders. Current clinical research failed to incorporate the observations of traditional descriptive psychopathology. CONCLUSIONS: Modern catatonia research operates with simplified versions of psychopathological terms devised and refined by generations of classical writers.

Catatonia↗
PubMed1995

Repeat mammography use among women ages 50-75.

It has been demonstrated clearly that the use of regular screening mammography reduces mortality among women ages 50 years and over. The primary objective of this study was to investigate factors associated with repeat mammography participation. A random sample of women ages 50-75 years residing in four Washington State counties was surveyed by telephone during mid-1989. The Health Belief Model was used as a conceptual framework for the analysis. Three groups of women with different mammography experiences in the previous 5 years were compared: (a) nonusers; (b) onetime users; and (c) repeat users. The survey response rate was 72%, and the study sample included 1357 women. One time users were more likely to have health insurance coverage, to visit a gynecologist or other primary care physician regularly, and to believe mammography is more effective than breast self-examination; they were less likely to think that at least 1 in 10 women are diagnosed with breast cancer or that mammography is inconvenient to obtain than were nonusers. Factors associated with repeat versus onetime use included routinely visiting a gynecologist, thinking the lifetime risk of breast cancer is at least 10%, and perceiving a high personal susceptibility to disease. Women who perceive themselves as being vulnerable to breast cancer are more likely to report repeat mammograms. Visiting a gynecologist regularly is associated with repeat as well as initial mammography use. These factors could be considered as the focus of promotional efforts moves from encouraging women to obtain their first mammogram to encouraging repeat use.

Aged↗
PubMed1994

Risk of breast cancer among young women: relationship to induced abortion.

BACKGROUND: Certain events of reproductive life, especially completed pregnancies, have been found to influence a woman's risk of breast cancer. Prior studies of the relationship between breast cancer and a history of incomplete pregnancies have provided inconsistent results. Most of these studies included women beyond the early part of their reproductive years at the time induced abortion became legal in the United States. PURPOSE: We conducted a case-control study of breast cancer in young women born recently enough so that some or most of their reproductive years were after the legalization of induced abortion to determine if certain aspects of a woman's experience with abortion might be associated with risk of breast cancer. METHODS: Female residents of three counties in western Washington State, who were diagnosed with breast cancer (n = 845) from January 1983 through April 1990, and who were born after 1944, were interviewed in detail about their reproductive histories, including the occurrence of induced abortion. Case patients were obtained through our population-based tumor registry (part of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute). Similar information was obtained from 961 control women identified through random digit dialing within these same counties. Logistic regression analysis was used to estimate odds ratios and confidence intervals (CIs). RESULTS: Among women who had been pregnant at least once, the risk of breast cancer in those who had experienced an induced abortion was 50% higher than among other women (95% CI = 1.2-1.9). While this increased risk did not vary by the number of induced abortions or by the history of a completed pregnancy, it did vary according to the age at which the abortion occurred and the duration of that pregnancy. Highest risks were observed when the abortion was done at ages younger than 18 years--particularly if it took place after 8 weeks' gestation--or at 30 years of age or older. No increased risk of breast cancer was associated with a spontaneous abortion (RR = 0.9; 95% CI = 0.7-1.2). CONCLUSION: Our data support the hypothesis that an induced abortion can adversely influence a woman's subsequent risk of breast cancer. However, the results across all epidemiologic studies of this premise are inconsistent--both overall and within specific subgroups. The risk of breast cancer should be reexamined in future studies of women who have had legal abortion available to them throughout the majority of their reproductive years, with particular attention to the potential influence of induced abortion early in life.

Abortion, Induced↗
PubMed1994

Use of diuretics and other antihypertensive medications in relation to the risk of renal cell cancer.

In a population-based case-control study of the association between use of diuretics and renal cell cancer, 120 white men whose cancer was diagnosed during the years 1980-1991 and 86 white women diagnosed in 1960-1991 were identified among members of the Kaiser Permanente Northwest health plan. Controls were plan members who had been individually matched to cases on sex, race, age, and time period in the plan. Data on diuretic use and other selected variables were abstracted from outpatient and inpatient medical records. In an analysis confined to exposures present at least 2 years before case diagnosis, the odds ratios associated with any use of a diuretic drug were 2.2 (95% confidence interval 1.2-3.9) for men and 1.8 (95% confidence interval 1.01-3.2) for women. Increased duration of diuretic use was associated with an increased risk of renal cell cancer. This association was not restricted to one class of diuretic and was not confounded by cigarette smoking or body mass. Both hypertension and use of nondiuretic antihypertensive drugs were closely associated with diuretic use, and it was impossible to disentangle fully the effects of these three separate exposures. These results, together with those of prior studies, are generally compatible with the view that there is an association between diuretic use and the incidence of renal cell cancer, but the interpretation of that association remains in question.

Aged↗
PubMed1994

Characterization of peroxidative oxidation products of dopamine by mass spectrometry.

We characterized three cytotoxic products, namely dopaminochrome (2,3-dihydro-1H-indole-5,6-dione), 2-(3,4-dihydroxyphenyl)-1-nitroethane and 2-(3,4,6-trihydroxyphenyl)-1-nitroethane. The compounds were separated from the incubation of dopamine (3,4-dihydroxyphenethylamine) with horseradish peroxidase which mimics the peroxidative activity of Prostaglandin H synthase. Incubation of 2-(3,4,6-trihydroxyphenyl)-1-nitroethane with NADPH-cytochrome c reductase led to the formation of 6-hydroxydopamine, a known neurotoxin. Several adducts were also isolated in this study. Oxidation of dopamine in the presence of N-acetylcysteine yielded a thioether conjugate namely, 5-S-(N-acetylcysteinyl)-3,4-dihydroxyphenethylamine. Reaction of the partially purified dopaminochrome with N-acetylcysteine permitted the isolation of another thioether conjugate which was tentatively identified as 7-S-(N-acetylcysteinyl)-5,6-dihydroxyindole. We also isolated the one-to-one condensation products of malonaldehyde with dopamine, norepinephrine and serotonin. The identities of these products were established by chemical synthesis and various mass spectrometric techniques.

Acetylcysteine↗
PubMed1994

Case-control study of malignant melanoma in Washington State. I. Constitutional factors and sun exposure.

Constitutional factors and sun exposure were examined among 256 cases of melanoma and 273 controls in three counties of western Washington State. Cases were individuals diagnosed with melanoma at ages 25-65 years during 1984-1987 who were identified from a Seattle-Puget Sound cancer registry. Population controls were identified through random digit dialing and were randomly selected, stratified by age, sex, and county. Participants completed a telephone interview with questions on demographic, sun exposure, and constitutional factors. Risk factors for melanoma were examined through the use of logistic regression, controlling for age, sex, and educational level, and data on each exposure variable were tested for the significance of trends across levels of exposure. The constitutional factor most strongly associated with melanoma risk was sun sensitivity, measured as either reaction to chronic sun exposure (for no tan vs. deep tan, odds ratio (OR) = 9.0, 95% confidence interval (CI) 3.8-21.1; p < 0.001 for trend across four categories) or reaction to acute sun exposure (for severe burn vs. tan, OR = 5.7, 95% CI 2.6-12.6; p < 0.001 for trend across four categories). The number of raised nevi counted on both arms by subjects was also associated with increasing risk (for > or = 10 nevi vs. none, OR = 5.7, 95% CI 2.2-14.6; p for trend < 0.001). Sun exposure in adulthood and occupational sun exposure were not related to melanoma risk. The effect of sun exposure in childhood on melanoma risk was modified by tanning ability. Poor tanners showed no effect of sun exposure at ages 2-10 years or ages 11-20 years. In contrast, people who reported a deep or moderate tan in reaction to chronic sun exposure appeared to be protected from melanoma with increasing sun exposure at ages 2-10 years (for upper third vs. lower third, OR = 0.3, 95% CI 0.2-0.6; p for trend < 0.001), with identical results for exposure at ages 11-20 years. The finding that childhood sun exposure is protective only among those able to tan supports the hypothesis that developing a tan during childhood may reduce the risk of melanoma by offering protection from the effects of sunlight exposure.

Adult↗
PubMed1994

Case-control study of malignant melanoma in Washington State. II. Diet, alcohol, and obesity.

Intakes of vitamin A, dietary antioxidants, and other dietary components were examined for their relation to the risk of malignant melanoma among 234 cases and 248 controls in three counties of western Washington State. Cases were drawn from persons diagnosed with melanoma between 1984 and 1987 and identified through a Seattle-Puget Sound cancer registry. Population controls were identified through random digit dialing and were randomly selected, stratified by age, sex, and county. Subjects completed a telephone interview and a mailed food frequency questionnaire asking for information on diet, demographic factors, and factors known to be associated with melanoma. Subjects were asked to estimate their food intake 7 years prior to diagnosis for cases and during a comparable time period for controls. Among data on 16 nutrients calculated from reported food intake, one significant finding emerged: Vitamin E obtained from food was inversely related to risk of melanoma (for highest quartile vs. lowest quartile, age-, education-, and energy intake-adjusted odds ratio (OR) = 0.34, 95% confidence interval (CI) 0.16-0.72; p for trend = 0.01). When intake of nutrients from food plus vitamin and mineral supplements was considered, zinc from food and supplements was associated with a decreased risk of melanoma (for highest quartile vs. lowest quartile, adjusted OR = 0.46, 95% CI 0.24-0.91; p for trend = 0.01). There was no evidence that vitamin A, preformed retinol, or carotenoids were associated with a decreased risk of melanoma or that alcohol or polyunsaturated fats were associated with an increased risk. Body mass index (weight (kg)/height (m)2) was significantly related to melanoma risk; cases were more obese than controls (for highest quartile vs. lowest quartile, age-, sex-, and education-adjusted OR = 1.90, 95% CI 1.10-3.27; p for trend = 0.02). These results provide limited support for the hypothesis that antioxidants such as vitamin E or cofactors in protection from oxidative damage such as zinc may be protective for melanoma, and they suggest that obesity should be measured in future studies of melanoma.

Adult↗
PubMed1994

Breast cancer among young U.S. women in relation to oral contraceptive use.

BACKGROUND: While most studies have found no association between oral contraceptive use and breast cancer, several studies of younger women have reported an association with long-term oral contraceptive use. PURPOSE. We studied the relationship of patterns of oral contraceptive use to breast cancer risk among younger women. These women have had oral contraceptives available their entire reproductive lives and are now entering the breast cancer-prone years. METHODS: A population-based, case-control study of breast cancer was conducted in three counties in western Washington State among women born in 1945 or later, ages 21-45. Case patients were 747 women with breast cancer diagnosed in 1983-1990 and identified through the Seattle-Puget Sound Surveillance, Epidemiology, and End Results cancer registry. Control subjects were 961 women identified by random-digit telephone dialing. Subjects were interviewed in person, using pictures of brands of oral contraceptives and calendars of life events as recall aids. RESULTS: There was no increased incidence of breast cancer associated with ever having used oral contraceptives. Because only 8% of this cohort had never used oral contraceptives, short-term users (< 1 year) were combined with never users as the reference group for further analyses. A small increased risk of breast cancer was associated with long duration of oral contraceptive use (odds ratio for > or = 10 years = 1.3; 95% confidence interval [CI] = 0.9-1.9; P for trend = .03), particularly among women aged 35 years or younger (odds ratio for > or = 10 years = 1.7; 95% CI = 0.9-3.1). Breast cancer was also modestly related to oral contraceptive use early in reproductive life (odds ratio for use within 5 years of menarche = 1.3; 95% CI = 1.0-1.8; P for trend = .04) and to use of high-progestin-potency oral contraceptives for at least 1 year (odds ratio = 1.5; 95% CI = 1.1-2.1). These associations were adjusted for age, age at menarche, term pregnancy, induced abortion, and family history of breast cancer. The associations were not further confounded by case-control differences in education, religion, breast feeding of offspring, or infertility; in oral contraceptive contraindications, indications, or complications; or in measures of breast cancer detection such as mammography or breast biopsy. CONCLUSIONS: Long-term oral contraceptive use among young women or use beginning near menarche may be associated with a small excess breast cancer risk, possibly due to susceptibility to genetic damage in breast epithelial cells at ages of high breast cell proliferative activity. IMPLICATIONS: Future studies should investigate whether the patterns of risk we reported are present as this cohort ages.

Adult↗
PubMed1994

Both viral (adenovirus E1B) and cellular (hsp 70, p53) components interact with centrosomes.

Human 293 cells, transformed by and expressing the early region of the adenovirus genome (i.e., E1A and E1B), contain a phase-dense cytoplasmic structure situated in close proximity to the nucleus. Via indirect immunofluorescence studies such structures have been previously shown to contain both the adenovirus E1B (55 kDa) protein as well as the tumor suppressor gene product p53. Here we show that such structures also stain positive for the cytoplasmic hsp 70 proteins. Such phase-dense structures containing hsp 70, p53, and adenovirus E1B are not unique to 293 cells but also are observed in rodent cell lines stabily transfected with the early region of the adenovirus genome. Using an antibody against a centrosomal protein, pericentrin, we show that these cytoplasmic phase-dense structures are in close proximity to the centrosome. Cell fractionation studies revealed such structures to be highly detergent insoluble. However, like the centrosome, the cytoplasmic phase-dense structures could be rendered detergent soluble following treatment of the cells with agents that disrupt the integrity of the cytoskeleton. While the phase-dense structures appear in close proximity to the centrosome in interphase cells, during mitosis the centrosome and the phase-dense bodies separate from one another. Owing to these observations we examined whether hsp70 and p53 might also co-localize with the centrosome in other cell types not expressing the adenovirus E1A/E1B proteins. We show that a portion of both hsp70 and p53 indeed are present within the centrosome in Hela, COS, and 3T3 cells. These observations raise the possibility that components like hsp70 and p53 may participate in the mechanism(s) controlling cell division in mammalian cells.

Adenovirus E1B Proteins↗
PubMed1994

Cancer survival among American Indians in western Washington State (United States).

Cancer survival among American Indians is worse than among other races in some regions of the United States, but has not been studied among American Indians in Washington state. Our purpose was to evaluate cancer survival among American Indians included in the Seattle-Puget Sound Cancer Registry. We compared site-specific survival among American Indians (n = 551) and Whites (n = 110,899) diagnosed from 1974 to 1989 for five cancer sites. For all sites except prostate, the distribution of cancer stage at diagnosis for American Indians was not significantly different from the distribution for Whites, and a similar proportion of American Indians and Whites received cancer treatment. After adjustment for age differences between American Indians and Whites, American Indians experienced poorer survival from prostate, breast, cervical, and colorectal cancer. Poorer survival among American Indians persisted after adjustment for differences in cancer stage at diagnosis, lack of cancer treatment, and residence in a non-urban county. The survival experience among American Indians who were recorded as non-American Indians in the cancer registry but who were listed as American Indians in Indian Health Service records was more favorable than that among persons initially coded as American Indians in the cancer registry. We conclude that cancer survival among American Indians in western Washington is poorer than that among Whites in the same region, and that factors other than age, differences in stage at diagnosis, lack of cancer treatment, and residence in non-urban counties account for this.

Age Factors↗
PubMed1994

Exogenous hormones, reproductive history, and colon cancer (Seattle, Washington, USA).

The associations between exogenous hormones, reproductive history, and colon cancer were investigated in a case-control study among women aged 30-62 years. The study was conducted in the Seattle, Washington (USA) metropolitan area between 1985 and 1989 and included 193 incident cases of colon cancer and 194 controls. There was little overall association between colon cancer and oral contraceptive use, parity, age at first birth, hysterectomy or oophorectomy status, or age at menopause. Use of noncontraceptive hormones at or after age 40, most likely hormone replacement therapy (HRT), was associated with decreased risk of colon cancer (adjusted odds ratio [OR] = 0.60, 95 percent confidence interval [CI] = 0.35-1.01), particularly among women with more than five years of use (OR = 0.47, 95 percent CI = 0.24-0.91). While results from previous studies have not been consistent, any protective effect of HRT against colon cancer would be important given the continuing debate over its potential risks and benefits.

Adult↗
PubMed1994

Alcoholism and cancer of the larynx: a case-control study in western Washington (United States).

Alcohol consumption is a well-known risk factor for laryngeal cancer. To determine whether alcoholism, as measured by responses to the Michigan alcoholism screening test (MAST), is a risk factor for laryngeal cancer independent of alcohol consumption, we analyzed data from a population-based case-control study. Personal interviews were conducted with 235 patients (81 percent response rate) with laryngeal cancer diagnosed from September 1983 through February 1987, who were residents of the Seattle metropolitan area. A total of 547 controls frequency-matched by age and gender, selected by random-digit dialing, were interviewed (75 percent response rate). When considered in a multivariate model, independent risk factors for laryngeal cancer included: alcohol consumption (42 or more drinks/wk compared with seven or less drinks/wk: odds ratio [OR] = 3.1, 95 percent confidence interval [CI] = 1.2-7.9); cigarette use (40 or more cigarettes/day compared with never-smoked: OR = 23.1, CI = 9.4-52.6); and weighted positive responses to the MAST (score of five or more compared with score of zero: OR = 1.9, CI = 1.1-3.4). Possible explanations for the association between alcoholism and laryngeal cancer are that a measure of alcoholism improves the accuracy of assessment of alcohol consumption, that alcoholism is associated with a pattern of alcohol consumption that increases the risk of laryngeal cancer, or that alcoholism may be a marker for host susceptibility to the carcinogenic effects of alcohol.

Adult↗
PubMed1994

The effect of exposure variance and exposure measurement error on study sample size: implications for the design of epidemiologic studies.

A small variability of exposure in a population, for example small variance in nutrient intake, limits the power of an epidemiologic study. McKeown-Eyssen and Thomas (J Chron Dis 1985; 38:559-568) have shown that by selecting a population with larger exposure variance vs one with smaller variance, the study sample size can be reduced by a factor equal to the ratio of the smaller to larger variance. The authors show that this benefit may be even greater for exposures measured with error. When there is measurement error, the sample size requirements are greatly increased. However, the proportional reduction in sample size from selecting a population with larger variance may be even greater when there is error than when there is not. Under certain assumptions, the validity of the exposure (correlation coefficient of the mismeasured exposure with the true exposure) is enhanced in the population with larger exposure variance, which provides the additional sample size benefit. Simple equations are presented that demonstrate quantitatively the substantial benefit of selecting a population with larger exposure variance when there is moderate or large measurement error. For example, selecting a population with a 30% greater standard deviation of exposure could reduce sample size requirements by 41% when the exposure is perfectly measured, but when the exposure is poorly measured with a validity coefficient of 0.6, the savings could be 56% if a population with 30% greater standard deviation of exposure could be studied. Applications of these results as well as the limitations of the assumptions are discussed.

Bias↗