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Biomedical subjects

F Levi

Publications and source records attributed to F Levi.

At least 235 records · Page 13Linked to original sources
PubMed1993

Dietary factors and the risk of endometrial cancer.

BACKGROUND: Endometrial cancer is associated with overweight, but little is known on its possible relationship with specific aspects of diet. METHODS: The relationship between dietary factors and the risk of endometrial cancer was investigated in a case-control study conducted in Switzerland and Northern Italy on 274 patients with histologically confirmed endometrial cancers and 572 control subjects admitted to the hospital for acute nongynecologic disorders that were not hormone related, metabolic, or neoplastic. RESULTS: Significant direct associations were observed with (1) the total energy intake (odds ratio [OR] for the highest versus the lowest consumption tertile = 2.7) and, after allowance for energy intake, (2) the frequency of consumption of most types of meats, eggs, beans or peas, added fats (OR for total added fat = 2.5), and sugar (OR = 2.5). Significant protection, of the order of 40-60% reduction in the highest versus the lowest consumption tertile, was conferred by elevated intake of most vegetables and fresh fruit and whole grain bread and pasta. This was reflected in the low OR for the highest tertiles of intake of beta-carotene and ascorbic acid (OR for the highest versus the lowest consumption tertile after allowance for energy intake = 0.5). CONCLUSIONS: The current study suggests that, aside from the predictable adverse effects of overeating and consequent overweight, some qualitative aspects of the habitual diet may also be associated with the risk of endometrial cancer, chiefly, the intake of animal proteins and fat (directly) and of fresh fruit, vegetables, and fibers (inversely).

Adult↗
PubMed1993

Trends in uterine cancer mortality in the Americas, 1955-1988.

Trends in uterine cancer mortality over the period 1955-1988 were analyzed for 14 selected Latin American countries and for the United States and Canada on the basis of the official death certification data from the World Health Organization database. In the late 1960s uterine cancer mortality in Latin America ranged from 7.8/100,000 in the Dominican Republic to 26.4/100,000 in Venezuela and was around 10/100,000 in the United States and Canada. Over the last two decades most Latin American countries (with the exception of the Dominican Republic and Ecuador) showed declines in mortality rates ranging from about 10% in Argentina and Mexico to 25-35% in Cuba, Chile, Uruguay, and Venezuela. These declines were however appreciably smaller than those in the United States and Canada, where falls in uterine cancer mortality approached 50%. In comparison with recent rates in the United States and Canada (around 5/100,000), mortality from uterine cancer was still high in all Central and South American countries (between 11 and 20/100,000), with the sole exception of Puerto Rico (6.3/100,000). The highest rates were in Paraguay and Ecuador (over 20/100,000). The overall variation in all age-standardized uterine cancer mortality in Latin America remained around threefold during the period 1965-1988 (i.e., between 22/100,000 in Paraguay and 6.3/100,000 in Puerto Rico). However, if the United States and Canada were also considered, the ratio between the highest and lowest mortality rate at all ages increased from about threefold during the period 1965-1969 to over fourfold in the late 1980s. This diverging pattern between North and Latin America was even clearer in young women (20-44 years), when most uterine cancer originates from the cervix, and less evident in the elderly. In the young, recent upward trends were observed in Argentina, Costa Rica, and the Dominican Republic. These mortality patterns are discussed with reference to risk factor exposure, cytologic screening programs, changes in hysterectomy rates, treatment, and case ascertainment and certification.

Adult↗
PubMed1993

Descriptive epidemiology of gall-bladder cancer in Europe.

Trends in mortality from cancer of the gall-bladder and bile ducts over the period 1965-1989 were analysed for 25 European countries on the basis of official death certifications from the World Health Organization databank. A high-mortality area--i.e. with overall death certification rates, world standard, around or over 2/100,000 men and 4/100,000 women in 1985-1989--was identified in Germany and the surrounding central European countries (Austria, Czechoslovakia, Hungary and Poland). The highest rates were in Hungary (3.9/100,000 men and 7.4/100,000 women). During the two decades considered, rates increased in Czechoslovakia and Hungary, remained stable in Poland and declined in Austria and Germany. Intermediate-mortality areas included Scandinavian countries (except Norway) and Switzerland: their rates in the late 1980s were between 1.5 and 2.5/100,000 men and between 2.2 and 4.2/100,000 women. Mortality increased in Finland and Sweden, declined in the Netherlands and Switzerland, and did not change consistently in Denmark. Low-mortality countries (i.e. with rates in 1985-1989 below 2.0/100,000 men and 2.5/100,000 women) included Belgium, France, Britain, Ireland, Norway, Bulgaria and Mediterranean countries. Over the last two decades, certification rates declined in Bulgaria and Great Britain, but increased in all other countries. The ratio between the countries with the highest and lowest gall-bladder cancer mortality rates declined from 21 to 12 in women, although they remained stable around 10 for men. The pattern was similar when analysis was restricted to truncated rates from patients aged between 35 and 64 years. These trends, and particularly the exceedingly high rates in central Europe, the low rates in Mediterranean countries and the low and declining rates in Britain and Ireland are discussed in terms of known (cholelithiasis) or potential (dietary) factors in gall-bladder cancer aetiology, and of trends in cholecystectomy rates.

Adult↗
PubMed1993

Oestrogen replacement treatment and the risk of endometrial cancer: an assessment of the role of covariates.

The relationship between oestrogen replacement treatment and the risk of endometrial cancer was analysed in a case-control study of 158 histologically confirmed incident cases below the age of 75 and 468 controls in hospital for acute, non-neoplastic, non-hormone-related conditions conducted in the Swiss Canton of Vaud in 1988-1992. Overall, 60 (38%) cases vs. 93 (20%) controls had ever used oestrogen replacement treatment: the corresponding multiple logistic regression relative risk (RR) was 2.7 (95% confidence interval, CI: 1.7-4.1). The risk was directly related to duration of use, and rose to 5.1 (95% CI: 2.7-9.8) for > 5 year-use. The RR was still significantly elevated 10 or more years after stopping use (RR = 2.3, 95% CI: 1.2-4.5). When the role of covariates was considered, a significant interaction was observed with body mass index (RR for long-term oestrogen use = 6.0 for lean or normal weight women vs. 2.4 for overweight women). There was also a hint of a negative interaction with oral contraceptive (OC) use, since the RR for oestrogens was higher (or restricted) to women who had never used OC (RR = 5.4, for long-term oestrogen use), as compared with those who had used OC, who showed no significant evidence of association with oestrogens (RR = 0.9 for long-term use). There was no significant interaction with cigarette smoking. Thus, this study confirms the presence of a strong association between oestrogen replacement treatment and endometrial cancer risk, since in the late 1980s or early 1990s about 25% of cases could be attributed to oestrogen replacement treatment in this Swiss population. Further, it confirms the presence of significant negative interactions of oestrogen use with obesity, and, possibly, with OC as well.

Adult↗
PubMed1993

Oxaliplatin activity against metastatic colorectal cancer. A phase II study of 5-day continuous venous infusion at circadian rhythm modulated rate.

Oxaliplatin (L-OHP) is a non-nephrotoxic third generation platinum complex with proven antitumoral activity and minimal haematological toxicity. Circadian scheduling has allowed significant increases in L-OHP dosage and dose intensity and decreases in its toxicities. This phase II trial has tested the antitumour activity of a 5-day circadian schedule of continuous venous infusion of L-OHP against metastatic colorectal cancer. Initial dose was 150 mg/m2/course. An intrapatient dose escalation scheme by 25 mg/m2/course was planned up to 200 mg/m2/course, according to toxicity criteria. The delivery rate of L-OHP was sinusoidally modulated along the 24-h time scale, and was highest at 1600 h. A programmable-in-time ambulatory pump was used, so that all patients could receive their treatment at home. 29 of 30 patients registered were eligible. 25 had failed previous chemotherapy. Three objective responses were observed (response rate: 10%), in patients progressive while on chemotherapy with 5-fluorouracil and folinic acid. Toxicity was moderate. Dose-limiting toxicities were diarrhoea and peripheral sensitive neuropathy. The latter adverse effect appeared to be cumulative. L-OHP, as delivered under this circadian schedule, exhibits clinical antitumour activity against metastatic colorectal cancer. These results, which await further confirmation, support the place of L-OHP in combination regimens including 5-fluorouracil.

Adult↗
PubMed1993

Diet and human oral carcinoma in Europe.

There are substantial variations in incidence and mortality from oral and pharyngeal cancer in Europe, with systematic tendencies towards increasing rates in most European countries, particularly in younger males. Most of the geographical differences are due to tobacco and alcohol consumption, which explain over three quarters of approximately 20,000 deaths from oral cancer registered every year in Europe, excluding the former Soviet Union. Nonetheless, dietary factors have an established and quantifiable role in oral carcinogenesis in Europe. Two studies showed a significant protective effect by vegetables and fresh fruit, which appeared particularly strong and consistent for fruit, but were not explained by measures of intake of beta-carotene or other micro-nutrients. Although it is not clear whether the observed associations simply reflected a generally poorer nutritional status of oral cancer cases, they open interesting perspectives for aetiological research and prevention, since about one in six oral cancers in European populations can be attributed to dietary deficiencies or imbalances.

Adult↗
PubMed1993

Selected physical activities and the risk of endometrial cancer.

The relationship between various indicators of physical activity and endometrial cancer risk was analysed using data of a case-control study conducted in 1988-1991 in Switzerland and Italy on 274 histologically confirmed cases and 572 controls admitted to hospital for acute, non neoplastic, non hormone-related diseases. Using a self-rated assessment of total physical activity, there was a systematic tendency for the cases to report more frequently 'low' or 'very low' physical activity. The relative risks were similar for 'very high' or 'moderately high' physical activity, but increased in the two lowest levels, with point estimates, in various decades of age, between 1.3 and 2.3 for 'moderately low' and over 2.5 for 'very low' physical activity. Although the association was apparently stronger at older ages, all the trends in risk were significant. Allowance for major identified potential distorting factors, including body mass index and a measure of total energy intake, could explain only in part the association, and the inverse trends in risk remained statistically significant. When selected types of physical activity were analysed, no association was observed with climbing stairs or walking, but the risk estimates for the lowest level of activity was over 4 for housework, and between 1.5 and 1.9 for sport and leisure and occupational activity. Thus, the present findings suggest that a moderate or high physical activity is an indicator of reduced endometrial cancer risk, although this observation still requires epidemiologic confirmation and clearer definition from a pathogenic point of view.

Activities of Daily Living↗
PubMed1993

Trends in lip cancer incidence in Vaud, Switzerland.

Recent trends in lip cancer incidence in the Swiss Canton of Vaud (approximately 600,000 inhabitants in 1990) were analysed over the period 1975-1990, when a total of 87 cases were registered. A steady and substantial decline was observed in both sexes, since age-standardised (world) rates declined from 1.8 to 0.6/100,000 males and from 0.14 to 0.02/100,000 females. These downward trends were evident across subsequent age groups. These trends were apparently not due to changes in registration or classification criteria in the study period and are discussed in terms of decreased occupational exposure to ultraviolet light, and reduced pipe and cigar smoking.

Adult↗
PubMed1993

Multiple primary cancers in the Vaud Cancer Registry, Switzerland, 1974-89.

Data collected by the Cancer Registry of the Swiss Canton of Vaud (whose population in 1980 was about 530,000 inhabitants) were used to estimate the incidence of second metachronous primary cancers following any specific neoplasm. Among 34,615 cases of incident neoplasms registered between 1974 and 1989 and followed through integrated active follow-up to the end of 1989, for a total of 118,241 person-years at risk, there were 2,185 second primaries (1,280 males, 905 females). For both sexes, the standardised incidence ratios (SIR) were significantly elevated by about 20%. Overall significantly elevated ratios were registered for cancers of the oral cavity and pharynx (SIR = 1.6 for males, 2.0 for females), oesophagus in males (SIR = 1.5), lung in males (SIR = 1.4), skin melanoma (SIR = 1.7 for males, 1.5 for females), non-melanomatous skin cancers (SIR = 1.6 for males, 1.5 for females), female breast (SIR = 1.3), kidney (SIR = 1.5 for males, 1.9 for females), and thyroid in males (SIR = 2.4). When specific first cancer sites were considered, the SIR following a cancer of the oral cavity and pharynx was around 3 in both sexes, mainly on account of a substantial excess of second primaries of the oral cavity, oesophagus, larynx and lung. The overall SIR following laryngeal cancer was 3.0, and significant excesses were observed for oral cavity and pharynx, oesophagus and lung. After lung cancer, the overall SIR was 1.7 for males and 2.6 for females, and significantly elevated SIRs were observed for oral cavity, lung and oesophagus. Following non-melanomatous skin cancers, elevated SIRs were observed in both sexes for skin melanoma and non-melanomas. The incidence of any cancer after breast cancer was significantly elevated (SIR = 1.2), mainly on account of an elevated risk of subsequent breast cancer (SIR = 1.7). With reference to cervical cancer, there was a significant excess for any subsequent primary (SIR = 1.6), and for lung cancer (SIR = 7.8). Significantly elevated SIRs were observed for kidney following bladder cancer, and for bladder after kidney cancer. In both sexes, the incidence of cancers of any site was elevated following leukaemias (SIR = 1.7 for males, 2.5 for females), and a significant excess was registered for lung in males and non-melanomatous skin cancers in both sexes.(ABSTRACT TRUNCATED AT 400 WORDS)

Female↗
PubMed1993

Dietary factors and breast cancer risk in Vaud, Switzerland.

The relationship between dietary factors and the risk of breast cancer was investigated in a case-control study conducted in the Canton of Vaud, Switzerland as a pilot phase for a larger cooperative study within the SEARCH Programme of the International Agency for Research on Cancer (Lyon, France). A total of 107 incident, histologically confirmed cases of breast cancer and 318 controls admitted to hospital for acute, nonhormone-related, gynecological, metabolic, or neoplastic disorders were interviewed. Significant direct trends in risk were observed with total energy intake [relative risk (RR) for highest vs. lowest intake tertile = 1.9] and, after allowance for energy intake, with frequency of consumption of various types of meat (RR = 2.1 for the highest tertile), cheese (RR = 2.7), and alcohol (RR = 2.1). Significant protections, on the order of 40-60% reductions for the highest vs. lowest consumption tertile, were conferred by total green vegetable consumption, selected types of vegetables and fruits (cucumbers, onions, pears), and a summary index of beta-carotene intake (RR = 0.4 for highest consumption tertile). Thus the present study confirmed the existence of an unfavorable dietary pattern for breast cancer risk (characterized by high-calorie, selected sources of animal fat and alcohol intake). Moreover, a significant protection could be gained by consuming a diet rich in vegetables and perhaps fruits.

Adult↗
PubMed1993

Circadian rhythms of circulating NK cells in healthy and human immunodeficiency virus-infected men.

Antiviral immunity involves NK cells, which circulate rhythmically every 24 hours. We have investigated circadian and 12-hour rhythms in the peripheral count of circulating NK cells in 15 men infected with human immunodeficiency virus (HIV) and 13 healthy controls. We analyzed three phenotypes using double-labeling with monoclonal antibodies and flow cytometry assessment: CD3- CD16+, CD3-CD57+, and CD2+CD3-. A statistical validation of time-dependent differences was achieved if significance (p < 0.05) was validated both with analysis of variance and cosinor. The circadian rhythm had a similar asymmetric waveform for the three phenotypes and is homogeneous on an individual basis. The circulating NK cell count peaked in the early morning and was low at night. A circadian rhythm and a circahemidian harmonic characterized all phenotypes in healthy subjects. We considered two groups of HIV-infected men: those who were asymptomatic (eight) and those with acquired immune deficiency syndrome (AIDS) (seven). Circadian changes in NK cell count were similar in both subgroups and in healthy controls. The circadian pattern was also consistent among individual patients. Asymptomatic HIV-infected men (early-stage disease) exhibited more pronounced 12-hour rhythmicity than did patients with AIDS or controls. The circulation of NK cells does not appear to share the same synchronizer(s) as other circulating T- or B-lymphocyte subsets. Thus, HIV infection gradually abolished circadian rhythmicity in circulating T and B cells, whereas it did not disturb that in NK cells.

Acquired Immunodeficiency Syndrome↗
PubMed1993

The impact of therapeutic improvements in reducing peptic ulcer mortality in Europe.

Trends in death certification rates from peptic ulcer between 1955 and 1989 have been analysed for 24 European countries on the basis of age-specific and age-standardized rates, and a log-linear model to estimate the effects of age, cohort of birth and period of death. For males, in all Western countries there were substantial declines in mortality. In the late 1950s, the range of variation of the world standardized rates was between 4/100,000 in France and 17.8 in Portugal. In the late 1980s, only Ireland had a rate over 5/100,000, and values for most Western countries ranged between 2 and 4/100,000. The average fall in rates over the last three decades was 56%. Of this, a high proportion (45%) was registered between 1975 and 1984. In Eastern Europe, no systematic change was observed until the early 1970s, but over the last 15 years peptic ulcer mortality declined by an average of 20%. In 1985-1989 the lowest rate was 4.5/100,000 in Bulgaria, and for all other countries peptic ulcer mortality ranged between 5 and 7.2/100,000. Peptic ulcer mortality was substantially lower in females, and showed no appreciable modification in Western Europe, and several increases in Eastern Europe until the mid 1970s. Thereafter, mortality declined by an overall 25% in the West and 15% in the East. Earlier declines for males in Western Europe were chiefly related to a cohort effect, reflecting more favourable risk factor exposure (such as diet, Helicobacter pylori or smoking) of subsequent generations. The recent falls, in contrast, were mainly on a period of death basis indicating therapeutic advancements (including the introduction of H2-receptor-antagonists in the mid-1970s) as the major determinant. These falls correspond to about 20,000 deaths from peptic ulcer avoided every year in the whole of Europe.

Cause of Death↗