Search PubMed⌕ Search

Biomedical subjects

G L Rubin

Publications and source records attributed to G L Rubin.

At least 55 records · Page 3Linked to original sources
PubMed1986

Alcohol consumption and ovarian cancer risk.

To study the influence of alcohol consumption on the risk of ovarian cancer in women under age 55, the authors examined data collected in a multicenter, population-based case-control study--the Centers for Disease Control's Cancer and Steroid Hormone Study. Between August 1981 and December 1982, 433 women 20-54 years of age with newly diagnosed ovarian cancer and 2,915 women 20-54 years of age selected at random from the same geographic areas were asked about their consumption of alcoholic beverages during the previous five years. Women who drank any alcohol during the five-year period had a risk of ovarian cancer of 0.9 (95% confidence interval (CI) = 0.7-1.2) compared with nondrinkers. Risk was not associated with the type of alcoholic beverage consumed, nor were the results affected by controlling for demographic characteristics and oral contraceptive use. Although there was no association between moderate alcohol consumption and ovarian cancer, women who drank more than about 20 drinks per week had a relative risk of ovarian cancer of 0.5 (95% CI = 0.2-0.9) compared with women who did not drink.

Adult↗
PubMed1986

Nutrient intake and supplementation in the United States (NHANES II).

Data from the second United States Health and Nutrition Examination Survey (NHANES II) suggest that almost 35 per cent of the US population 18 to 74 years of age takes vitamin/mineral supplements regularly. Both higher nutrient intake and use of vitamin supplementation are associated with older ages, higher income, higher education level, and White race. Accounting for differences associated with sex, age, race, income, and education, persons with higher nutrient intakes remain more likely to take vitamin supplements.

Adolescent↗
PubMed1986

Vasectomies performed by private physicians, United States, 1980 to 1984.

Using data from the National Disease and Therapeutic Index, we estimated that between 1980 and 1984, 1.9 X 10(6) U.S. men had vasectomies. Men between the ages of 30 and 39 years, and white men, were more likely than others to undergo the procedure. Further national data on this popular procedure are needed.

Adult↗
PubMed1985

Oral contraceptives and breast cancer in young women.

The relation between use of oral contraceptives (OCs) by young women and their risk of breast cancer before 45 years of age was investigated by analysis of data from a population-based, case-control study conducted in eight geographic regions of the United States. 2088 women with breast cancer diagnosed between Dec 1, 1980, and Dec 31, 1982, were compared with 2065 controls selected during the same period. There was no significant increase or decrease in the risk of breast cancer for OC users according to age at first use or subsequent duration of use, even for women who first used OCs before the age of 20 years and who continued to use them for more than 4 years. Risk was not altered significantly for women who used OCs with high progestagen "potency" before the age of 25 years (even when duration of use exceeded 6 years), for those who used OCs before first-term pregnancy (even when duration of use exceeded 4 years), or for OC users according to age at diagnosis. These results suggest that use of OCs by young women in the United States has no effect on the aggregate risk of breast cancer before 45 years of age.

Adult↗
PubMed1985

The mortality risk associated with hysterectomy.

To study the risks of mortality associated with hysterectomy that are specific to age, race, surgical approach, and associated conditions, we used data collected by the Commission on Professional and Hospital Activities during 1979 and 1980. Four hundred seventy-seven deaths were recorded among 317,389 women having abdominal hysterectomies and 46 deaths among 119,972 women having vaginal hysterectomies. The mortality rates for hysterectomy, standardized for age and race, were higher for procedures associated with pregnancy or cancer than for procedures not associated with these conditions (29.2, 37.8, and 6.0 per 10,000 procedures, respectively). Hysterectomies associated with pregnancy or cancer constituted 8% of all hysterectomies performed. However, 61% of all deaths occurred in women with pregnancy- or cancer-related conditions. The mortality rate associated with hysterectomy increased with age and was twice as high among black women.

Adult↗
PubMed1985

Safety of abortion and tubal sterilization performed separately versus concurrently.

Concurrent abortion and sterilization are preferred by many women to avoid a second hospitalization, operation, and, in some instances, general anesthesia. Several authors have shown concern, however, that the two procedures carry a higher risk of morbidity when performed concurrently versus separately. To determine whether the concurrent performance of sterilization and induced abortion is as safe as the two procedures performed separately, we selected women undergoing these procedures from two separate multicenter, prospective, national United States studies: the Joint Program for the Study of Abortion and the Collaborative Review of Sterilization. Using standard definitions of major morbidity, we calculated the crude rate of one or more major complications to be 0.9% for the abortion-only group, 1.7% for the group concurrent abortion and tubal sterilization. Thus our data suggest that performing concurrent abortion and sterilization is as safe as performing those procedures separately.

Abortion, Induced↗
PubMed1985

Family history and the risk of breast cancer.

To investigate whether a family history of breast cancer increases a woman's risk of developing breast cancer, we analyzed data from the Centers for Disease Control's Cancer and Steroid Hormone Study. The 4,735 cases were women 20 to 54 years old with a first diagnosis of breast cancer ascertained from eight population-based cancer registries; the 4,688 controls were women selected at random from the general population of these eight areas. Compared with women without a family history of breast cancer, women who had an affected first-degree relative had a relative risk of 2.3; women with an affected second-degree relative had a relative risk of 1.5; and women with both an affected mother and sister had a relative risk of 14. The risk of breast cancer for a woman was higher if her first-degree relative had unilateral rather than bilateral breast cancer or had breast cancer detected at a younger rather than older age. For women aged 20 to 39, 40 to 44, and 45 to 54 years, the estimated annual incidence of breast cancer per 100,000 women attributable to a first-degree family history of breast cancer was 51.9, 115.1, and 138.6, respectively, and that attributable to a second-degree family history of breast cancer was 12.1, 19.2, and 92.4, respectively.

Adult↗
PubMed1985

Endometrial cancer: how does cigarette smoking influence the risk of women under age 55 years having this tumor?

This analysis of the Cancer and Steroid Hormone Study, a multicenter, population-based case control investigation of hormone use by women of reproductive age and endometrial, breast, and ovarian cancer shows that cigarette smoking is not associated with either an increased or a decreased risk of endometrial cancer. This study included 437 women with endometrial cancer and 3200 control subjects, all of whom were between the ages of 20 and 54 years at the time of interview. The absence of any alteration of the risk of endometrial cancer and smoking was found consistently no matter which variable was used as a measure of smoking--ever or never smoked cigarettes, former or current smoking, light or heavy smoking, or age smoking began.

Adult↗
PubMed1985

Regret after decision to have a tubal sterilization.

To determine characteristics associated with regretting sterilization that can be determined preoperatively, we analyzed data from the Collaborative Review of Sterilization (CREST), a multicenter, prospective, observational study. Of 5022 women, 2.0% regretted having had a tubal sterilization at 1 year after the procedure and 2.7% did so after 2 years. Using a multivariate analysis to identify risk factors for regret, we found that almost all characteristics were more closely associated with regret at 1 year than at 2 years postoperatively. Of the characteristics we examined that could be objectively determined preoperatively, we considered only age less than 30 years and (for whites) a concurrent cesarean section to be risk factors for regret at 2 years after sterilization. However, in absolute terms, less than 10% of women with both those risk factors regretted having the procedure.

Adolescent↗
PubMed1985

Hysterectomy performed within 1 year after tubal sterilization.

In the United States, approximately 650,000 women of reproductive age undergo tubal sterilization each year and some of these women later have hysterectomies. Little is known about risk factors for having hysterectomy after tubal sterilization. For examination of this issue, we analyzed data from the Collaborative Review of Sterilization, an ongoing multicenter prospective study designed to assess the safety and efficacy of female sterilization operations. In 1979 and 1980, 4002 women 15 to 44 years of age had interval tubal sterilization; of these women, 64 had hysterectomies within 15 months, which yielded a cumulative incidence of 1.6%. Women with a history of menstrual complaints, leiomyomata, ovarian cysts, or endometriosis before their tubal sterilization had an increased risk of hysterectomy, compared with women without such a history. However, 98% of women with a history of these conditions did not have a hysterectomy within 15 months after tubal sterilization. Further follow-up of these women should help to better delineate their long-term risks.

Adolescent↗
PubMed1985

Contraceptive use before tubal sterilization.

A woman's decision to undergo tubal sterilization may be affected by her experience with temporary contraception. To examine this issue we analyzed data from the Collaborative Review of Sterilization, a multicenter, prospective study of the health effects of sterilization operations on women aged 15-44 years. Data on contraceptive use by a comparison group of nonsterilized women were drawn from a random, population-based sample of women aged 20-44 years who were controls in a large study of cancer and steroid hormone use. Sterilized women reported ever using a higher average number of contraceptive methods than did nonsterilized women. As compared with nonsterilized women, a higher percentage of sterilized women reported ever using contraceptives (99% versus 91%), especially two types, barrier and rhythm or withdrawal. Prior to selecting sterilization as a permanent contraceptive method, the sterilized women had more extensive experience with temporary contraceptives, particularly the less effective ones, than did the comparable nonsterilized women.

Adult↗
PubMed1985

Characteristics of vasectomies performed in selected outpatient facilities in the United States, 1980.

In 1981 the American Association of Gynecologic Laparoscopists and the Division of Reproductive Health, Centers for Disease Control, jointly conducted a study of vasectomies performed in outpatient facilities in 1980 in the United States. One hundred twenty-nine facilities that responded to either a mailed questionnaire or a telephone interview stated that vasectomies were performed there in 1980. The average cost was $273, with a range of $50-1,000. Facilities differed markedly in the use of anesthesia. Freestanding surgical centers reported the use of general anesthesia for 29% of the vasectomies. Other types of facilities were more likely to use local or regional anesthesia. Our data suggest areas for further research to improve the availability and safety of vasectomy.

Anesthesia, General↗
PubMed1984

Confirmation of the preoperative diagnoses for hysterectomy.

Few previous studies have examined the relationship between the preoperative and pathologic diagnoses for hysterectomy. To determine the percentage of preoperative diagnoses that were confirmed by pathologic examination, we analyzed data from the Collaborative Review of Sterilization, a multicenter study of hysterectomies and tubal sterilizations in women aged 15 to 44 years. Data were collected from patient interviews and chart reviews. Of the 1851 women included in this study, 1283 (69%) had abdominal hysterectomies and 568 (31%) had vaginal hysterectomies. Overall, 52% of the hysterectomies were performed for a preoperative diagnosis that could potentially be confirmed by pathologic examination. Pathologic examination actually confirmed the preoperative diagnosis of endometrial hyperplasia in 95% of the cases, cervical intraepithelial neoplasia in 89%, leiomyomas in 84%, pelvic inflammatory disease in 75%, adenomyosis in 48%, and endometriosis in 47%. Among all of the potentially confirmable diagnoses, 80% were confirmed. The remaining 48% of the women who had hysterectomies had preoperative diagnoses that were not amenable to confirmation by pathology. Most of these were for one of three diagnoses: menstrual bleeding disorders, pelvic pain, or pelvic relaxation. In 47% of these cases, pathologic examination showed leiomyoma or adenomyosis; no abnormalities were found in 38% of these cases.

Adolescent↗
PubMed1984

Mortality among young black women using contraceptives.

Data on the risk of death associated with various contraceptive methods are incomplete. Therefore, we analyzed the mortality rates for young, black inner-city women who used one of four methods of contraception--oral contraceptives, depomedroxyprogesterone acetate, intrauterine (contraceptive) devices, and barrier methods. The subjects were 30,580 15- to 44-year-old women who enrolled at a family planning clinic between 1967 and 1972 and who were observed by monitoring death certificates through the end of 1977. Forty percent of the 218 deaths observed were from accidents and violence. Use of this family planning clinic greatly reduced the risk of death from childbearing; only two deaths were associated with pregnancy and childbirth, compared with the 24 deaths expected. Overall, users of the four methods died at similar, low rates. Given that this study involves considerable loss to follow-up, possible acute effects of contraceptives (eg, infections or thrombosis) are more accurately estimated than possible long-term effects (eg, cancer).

Adolescent↗
PubMed1984

Sterilization-associated deaths: a global survey.

Except for data from several geographically limited studies, little is known globally about the number and causes of death associated with surgical sterilization. To identify clinical characteristics and problems leading to deaths related to the procedures, the International Planned Parenthood Federation ( IPPF ) and the Centers for Disease Control (CDC) in the United States collaborated in a global mail survey of 4642 physicians. Usable responses were received from 1298 physicians (28%) in 80 countries. Fifty-five sterilization-associated deaths which occurred from January 1, 1980 to June 30, 1982 were reported. The most frequently reported causes of death were infection, anesthetic complications, and hemorrhage. There were some regional differences in the relative frequencies of these causes. Most cases did not involve surgical accident. The characteristics most frequently associated with the reported fatal procedures were: interval sterilizations, minilaparotomy incision, tubal ligation and general anesthesia. Most deaths were attributable to the surgical sterilization procedure.

Adolescent↗