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Biomedical subjects

H Austin

Publications and source records attributed to H Austin.

At least 73 records · Page 4Linked to original sources

A prospective follow-up study of cancer mortality in relation to serum DDT.

Serum DDT and DDE levels were measured in 919 subjects in 1974 and 1975. Two-hundred and nine of the subjects died, including 54 from cancer, during a 10-year prospective follow-up period. There was no relation between either overall mortality or cancer mortality and increasing serum DDT levels. There was weak evidence of a positive relation between respiratory cancer mortality and serum DDT. The literature on DDT and human cancer is reviewed, and it is concluded that the evidence does not support the opinion that DDT is a human carcinogen.

Adult↗

A clinical trial of nonoxynol-9 for preventing gonococcal and chlamydial infections.

A randomized, double-blind, placebo-controlled trial was conducted to evaluate the spermicidal agent nonoxynol-9 as prophylaxis for cervical infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae. Eight hundred eighteen women were recruited from a sexually transmitted disease clinic. Only subjects who were using reliable birth control methods (oral contraceptives, intrauterine device, or sterilization) were eligible. Subjects were randomly assigned to use either a commercially available spermicidal agent containing nonoxynol-9 or a placebo preparation. Subjects were followed up for six months; specimens were collected monthly for culture of the two pathogens. Women assigned to the nonoxynol-9 group were less likely to become infected with N. gonorrhoeae (relative rate, 0.75; 90% confidence limits, 0.58 and 0.96) and C. trachomatis (relative rate, 0.79; 90% confidence limits, 0.64 and 0.97). Among women who used their assigned gel for the majority of coital episodes, a stronger protective effect was observed.

Adult↗

Benzene and leukemia. A review of the literature and a risk assessment.

Benzene is widely recognized as a leukemogen, and the Occupational Safety and Health Administration is currently attempting to limit exposure to it more strictly. The proposed new regulation is a limit of an eight-hour time-weighted average of 1 ppm in place of the current limit of 10 ppm. The fundamental rationale for the change is a perception that the current standard is associated with an inordinate excess of leukemia. The epidemiologic literature on benzene and leukemia supports the inference that benzene causes acute myelocytic leukemia. However, the available data are too sparse, or suffer other limitations, to substantiate the idea that this causal association applies at low levels (i.e., 1-10 ppm) of benzene. Nonetheless, under the assumption that causation does apply at such low levels, a number of authors, including ourselves, have performed risk assessments using similar data but different methodologies. The assessments that we consider acceptable suggest that, among 1,000 men exposed to benzene at 10 ppm for a working lifetime of 30 years, there would occur about 50 excess deaths due to leukemia in addition to the baseline expectation of seven deaths. However, this estimate is speculative and whether or not enough confidence can be placed in it to justify a lower occupational benzene standard remains a decision for policy makers.

Benzene↗

Assessing the performance of information technology.

Most hospital executives have difficulty assessing the impact of information technology (IT) and the performance of IT personnel. This article describes three management visions for IT--automate, informat and transform--and seven assessment procedure for determining which vision may be most relevant to a specific hospital.

Efficiency↗

Strategic automation for surgery.

Recent advances in automated systems for surgical department management include enhancements in management methodology and improved economics of the surgical suites. Requirements of accountability legislation have stimulated development of a new generation of highly efficient software applicable to the surgical suite. These include surgical scheduling, preference lists in picking order, materials management, surgically related data and statistics, deployment of personnel and assignment of facilities. With recent advances in computer hardware and the availability of applicable software, the return on investment of these systems makes them affordable. Strategic surgical software can improve productivity, accuracy, efficiency of service and quality control while enhancing revenues to a surgical department.

Computers, Mainframe↗

Case-control study of hepatocellular carcinoma, occupation, and chemical exposures.

The relation of hepatocellular carcinoma (HCC) to occupation and chemical exposures was evaluated in a case-control study. The study included 80 cases and 146 matched hospital controls on whom a work history was obtained. No persuasively positive association between HCC and any particular occupation, industry, or chemical exposure was found. However, the relative rate (RR) of HCC for persons employed in highway construction compared with those never so employed is 5.0 with 95% confidence limits (CL), 1.0 to 26. The RR for farming occupations, 1.4 (95% CL, 0.7 to 2.9), is also slightly elevated. The RR for persons exposed to pesticides compared with those not exposed is 2.4 (95% CL, 0.9 to 6.5). Asphalt exposures are associated with a RR of 3.2 (95% CL, 0.9, 11). These findings are compared to the results of other epidemiologic studies.

Adult↗

A case-control study of hepatocellular carcinoma and the hepatitis B virus, cigarette smoking, and alcohol consumption.

A case-control study was undertaken to evaluate the roles of the hepatitis B virus (HBV), cigarette smoking, and alcohol use in the etiology of hepatocellular carcinoma (HCC). A major purpose of the study was to evaluate the effect of cigarette smoking on HCC among hepatitis B surface antigen (HBsAg)-negative persons, since it had been suggested that the relative effect of cigarette smoking on HCC was higher among HBsAg-negative persons than among HBsAg-positive persons. Eighty-six cases and 161 hospital controls were included in the study. This study confirmed the strong relationship between the HBV and HCC. Twelve of 67 cases and none of 63 controls were chronically infected with HBV as evidenced by serum HBsAg. The study also found a moderately strong relationship between alcohol use and HCC. The results of the present study do not support the hypothesis that cigarette smoking is a risk factor for HCC. Among all subjects, the relative rate of HCC for cigarette smokers compared with nonsmokers after adjustment for alcohol consumption was 1.0 with 95% confidence limits, 0.5 to 1.8. Among HBsAg-negative subjects, the relative rate was 1.1 with 95% confidence limits, 0.5 to 2.4. There was also no consistent dose-response relationship between quantity smoked and HCC in this study.

Adult↗

A case-control study of leukemia at an oil refinery.

A previous retrospective follow-up mortality study of white men employed at an oil refinery found an excess of leukemia deaths, especially of acute myeloid leukemia (AML). A case-control study was done to determine if the excess could be related to any particular jobs or departments at the refinery or to benzene exposures. The study includes 14 cases with leukemia (eight cases with AML) and 50 matched controls. No particular job or department was identified as the likely source of the excess leukemia deaths. Furthermore, the cases apparently had not been exposed to more benzene than had the controls. Thus, the reason for the excess leukemia at this refinery was not identified. The limitations of the study are discussed.

Benzene↗

A case-control study of spermicides and gonorrhea.

A case-control study was done to evaluate the effectiveness of vaginal spermicides as a prophylaxis against gonorrhea. The subjects included 735 women with gonorrhea and 958 controls seen in a sexually transmitted disease clinic. The relative risk (RR) of gonorrhea for spermicide users compared with nonusers was 0.67 with 90% confidence limits, 0.44 to 1.0. This RR was 0.47 (90% confidence limits, 0.25 to 0.87) after the exclusion of women using oral contraceptives, an intrauterine device, or with a tubal ligation. The protective effect of spermicides was confined largely to women who had also used diaphragms or whose partners had used condoms. The RR of gonorrhea for spermicide and condom users relative to nonusers of spermicides, condoms, and diaphragms was 0.41 (90% confidence limits, 0.21 to 0.79), while for spermicide and diaphragm users, this RR was 0.45 (90% confidence limits, 0.15 to 1.3). These results suggest that a woman can appreciably decrease her risk of contracting gonorrhea if she uses spermicides in conjunction with either the diaphragm or the condom.

Adult↗