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H O Adami

Publications and source records attributed to H O Adami.

At least 343 records · Page 19Linked to original sources
PubMed1987

On the age-dependent association between cancer of the breast and of the endometrium. A nationwide cohort study.

The association between breast and endometrial cancer was investigated in a cohort consisting of 60,065 subjects (99% of all women in whom a first breast cancer was diagnosed in Sweden in 1960-63 and 1968-81). Complete follow-up until 1981 revealed a total of 260 endometrial cancers, as against an expected number of 151.1 (relative risk (RR) = 1.72; 95% confidence limits (CL) 1.46; 1.87). RR increased steadily from close to unity in women younger than 50 at breast cancer diagnosis to 2.40 (CL 1.97; 2.93) in those 70 years of age and older. The excess number of endometrial cancers occurred primarily during the first five years of follow-up (RR = 2.07; CL 1.79; 2.38). A common causal agency for breast and endometrial cancer is more likely to lie in environmental than in genetic factors and other observations in the same population do not support that such factors are related to characteristics of the women's reproductive histories.

Adult↗
PubMed1987

Reliability of women's histories of climacteric oestrogen treatment assessed by prescription forms.

A questionnaire study conducted in a cohort of women who had been prescribed oestrogen treatment for climacteric symptoms provided a unique opportunity to assess the concordance between their histories of oestrogen use and the exposure data derived from the prescription forms that had been collected for recruitment of the cohort. The questionnaire information, which was gathered within three years after the registration of prescription forms, was found to be highly concordant with the prescription data with respect to name of brand (85%), dosage (88%), treatment schedule--cyclic versus continuous--(88%), total duration of drug intake (months of treatment; correlation coefficient 0.98) and time of start of medication (correct month in 85%). A method for estimating the true exposure on the basis of prescription data--taking into account non-compliance and non-registered forms--was developed and found to be reproducible. It was concluded that information on climacteric oestrogen intake could be reliably obtained through a questionnaire within a period of less than three years after the exposure.

Adult↗
PubMed1987

Epidemiologic determinants of the mammographic parenchymal pattern. A population-based study within a mammographic screening program.

Epidemiologic data and information on the mammographic parenchymal pattern (classified according to Wolfe (Cancer 1976;37:2486-92)) were obtained from 38,757 (89%) of all women who were invited to undergo mammography in a population-based screening program in Kopparberg County, Sweden, starting in October 1977. The prevalence of the high-risk patterns (P2 and DY) was significantly higher in women aged 46-50 years than in any younger or older age group. A univariate analysis revealed that the odds ratio (OR) of having a high-risk pattern increased regularly with increasing age at first birth and was highest in nulliparous women. These associations remained evident in all age groups and were most pronounced in the oldest women. A history of breast biopsy increased the likelihood of having a high-risk pattern (OR = 1.57), whereas a similar weak overall association with prior cancer in the contralateral breast (OR = 1.40) and with familiar occurrence of breast cancer (OR = 1.20) was eliminated when other confounding factors were considered in a multivariate analysis. The authors conclude that characteristics of the reproductive lives of women have a significant and lifelong impact on their mammographic parenchymal patterns.

Adult↗
PubMed1987

Psychological group counseling for the prevention of ulcer relapses. A controlled randomized trial in duodenal and prepyloric ulcer disease.

The effect of psychological counseling on 1-year ulcer relapse rate of recurrent duodenal and prepyloric ulcer disease was evaluated in 148 patients randomly allocated into three treatment groups; psychological counseling group, maintenance cimetidine (400 mg at bedtime), and placebo cimetidine at bedtime. Ulcer relapses were monitored by endoscopy at 6 and 12 months after inclusion and at symptomatic recurrence. The estimated proportion of relapse-free patients after 12 months follow-up in the psychological counseling group (0.43 +/- 0.08) did not differ significantly from the placebo group (0.47 +/- 0.07), whereas the corresponding value for the cimetidine group (0.70 +/- 0.07) was significantly higher (p less than 0.01). The effect of cimetidine on ulcer recurrence, however, was confined to smokers; relapse risk among nonsmokers did not differ significantly between the treatment groups. The negative outcome of psychological counseling raises doubts as to whether duodenal or prepyloric ulcer recurrences can be prevented by such a therapeutic approach.

Adolescent↗
PubMed1987

Is duodenal ulcer really a psychosomatic disease? A population-based case-control study.

Risk factors for prepyloric and duodenal ulcer were analysed by means of a questionnaire in 132 patients and 132 population controls, pairwise matched for age and sex. Several factors associated with a lower socioeconomic status, such as short education, low income and low housing standard, and a job characterized by low satisfaction, low demands, and low autonomy, were more prevalent among the patients. The odds ratio (OR) with 95% confidence limits (CL) in smokers versus non-smokers was 2.9 (CL, 1.7-5.0). A trend emerged in relation to the daily number of cigarettes, with an OR of 4.1 (CL, 2.2-7.5) for those smoking more than 10 cigarettes. The risk of having peptic ulcer disease was virtually unrelated to other psychiatric and somatic morbidity, to marital status, personal worries, type-A behaviour, experience of a hectic or psychologically demanding job, and to consumption of coffee, alcohol, and drugs. Our data lend no support to the concept that peptic ulcer disease is a disorder related to psychologic stress. Causative agents other than smoking should probably be sought among factors characterizing the life style of low socioeconomic classes.

Adolescent↗
PubMed1987

Long-term survival in malignant melanoma with special reference to age and sex as prognostic factors.

A total of 12,353 (97.5%) of all patients with a first malignant melanoma newly diagnosed in Sweden during the period 1960-82 were subjected to a complete computerized follow-up with respect to survival through December 31, 1982. Calculation of relative survival rates (RSs) revealed a consistently more favorable course in women than in men, the 5-year RSs being 80.8 and 68.0% and the 10-year RSs being 75.0 and 61.8%, respectively. Prolonged follow-up and analyses of annual excess mortality showed, in addition, that men surviving about 10 years constituted an apparently cured fraction, whereas among women there was an excess mortality throughout the observation period. The prognosis was increasingly more favorable at younger ages in males, whereas no regular age trend emerged in the female group of patients. A multivariate analysis indicated that the findings were not confounded by temporal trends in RSs or by differences in tumor location between the groups compared and also that the relative hazard was significantly higher for men than for women only during the first 8 years after diagnosis.

Adult↗
PubMed1987

Mortality after surgery for primary hyperparathyroidism: a follow-up of 441 patients operated on from 1956 to 1979.

Four hundred forty-one patients who were operated on for primary hyperparathyroidism were observed for up to 22 years. Mortality was significantly higher than expected during the first postoperative years, for both men and women. This was predominantly due to a higher than expected incidence of diseases of the circulatory organs. The greater risk of death--compared with the expected mortality in the general patient population--appeared to decrease after the initial 5 to 8 postoperative years. However, for the entire follow-up period, the cumulative survival ratio (i.e., the ratio between the expected and the observed rates) was less than 1 for both sexes. The preoperative concentration of serum calcium did not influence the survival rates. The findings are consistent with the hypothesis that untreated hyperparathyroidism carries an increased risk of death, particularly from cardiovascular diseases but that this risk is gradually reduced after surgery.

Actuarial Analysis↗
PubMed1987

The "epigastric distress syndrome". A possible disease entity identified by history and endoscopy in patients with nonulcer dyspepsia.

Nonucler dyspepsia lacks a clear definition, and probably conceals several entities under this heading. It seems appropriate to deal separately with symptoms likely to be elicited from the upper digestive tract. Therefore, we propose "epigastric distress syndrome" (EDS) as a designation for chronic or recurrent epigastric pain without any anatomical antecedents and without concomitant symptoms consistent with established criteria of the irritable bowel syndrome. In this study 185 dyspeptic patients with a tentative diagnosis of EDS, based on symptoms and negative upper endoscopy, underwent laboratory screening, peroral cholecystograms, ultrasound scanning of the liver, biliary tract, and pancreas, biopsies from the distal part of the duodenum, and acid secretory tests. There were very few pathological findings. Five patients had gallstones. No single case of chronic pancreatitis or celiac disease was disclosed. Thus, EDS seems to be a "safe" diagnosis, and it is not unreasonable to assume that it could represent a disease entity. Although many patients had symptoms closely similar to those in duodenal ulcer, the mean basal and maximal acid output in this patient category did not differ from that observed among healthy subjects.

Adolescent↗
PubMed1987

Self-rating of pain in nonulcer dyspepsia. A methodological study comparing a new fixed-point scale and the visual analogue scale.

Little attention has been paid to methodological aspects in the recording of gastrointestinal symptoms. We compared a new fixed-point scale for the self-recording of pain intensity with steps operationally linked to behavioral events and with additional monitoring of pain duration--termed the "duration-intensity-behavior scale" (DIBS)--with the visual analogue scale (VAS) in 32 patients with nonulcer dyspepsia. After randomization, the patients either recorded pain intensity (VAS) or pain intensity and duration (DIBS) four times daily during a 4-week period for 1 preliminary week without medication, followed by 3 weeks of antacid treatment. For both scales there was a high degree of compliance, and they seemed equally reliable and sensitive to changes in pain experience. Since DIBS yields more clinically useful information, this scale appears to be preferable for the monitoring of gastrointestinal pain.

Adult↗
PubMed1986

Demands on surgical inpatient services after mass mammographic screening.

The changes in the demand for surgical inpatient care created by mammographic screening for breast cancer were analysed by comparing two counties, one with and one without a mass screening campaign. A comprehensive computerised register of inpatient care in the region was used. The results indicate that population based screening offered to women above 40 years and repeated every two to three years will increase the number of operations required for breast cancer and inpatient days by at least 150% during the initial screening round. During the second round the figures tend to return to previous levels. Of decisive importance for the demands on health service resources are the specificity of screening, the duration of the first screening round, and the age groups included.

Adolescent↗
PubMed1986

Oral contraceptive use and breast cancer in young women. A joint national case-control study in Sweden and Norway.

The possible association between oral contraceptive (OC) use and the risk of breast cancer developing before the age of 45 was investigated by means of a population based case-control study in Sweden and Norway. Information was obtained by personal interview from 422 (89.2%) of all eligible patients with a newly diagnosed breast cancer from May, 1984, to May, 1985, and from 722 (80.6%) of all contacted age-matched controls. A multivariate analysis, which accounted for several possible confounding factors, revealed a significant (p = 0.03) association between total duration of OC use and breast cancer risk. The relative risk (RR) of breast cancer after 12 or more years of OC use was 2.2 (1.2-4.0). OC use for more than 7 years before first full-term pregnancy entailed an increased breast cancer risk (RR = 2.0 [1.0-4.2]) which was of borderline significance. When total duration of use was considered, the risk of breast cancer was virtually unrelated to age at first OC use and latency from first use. The results suggest that long-term use of OCs may increase the risk of breast cancer in young women.

Adult↗
PubMed1986

The relation between survival and age at diagnosis in breast cancer.

We analyzed the relation between age at diagnosis and relative survival (ratio of observed to expected survival) in 57,068 women in Sweden in whom breast cancer was diagnosed in 1960 to 1978 (about 98 percent of all cases). Women who were 45 to 49 years old had the best prognosis, with a relative survival exceeding that of the youngest patients (less than 30 years) by 7.6 to 12.9 percent at different periods of observation. Relative survival declined markedly after the age of 49--particularly in women aged 50 to 59--and the oldest women (greater than 75) had the worst rate. The difference in relative survival between those older than 75 and those 45 to 49 increased from 8.6 percent at 2 years to 12.2, 20.3, and 27.5 percent after 5, 10, and 15 years of follow-up, respectively. The long-term annual mortality rate due to breast cancer approached 1 to 2 percent at the premenopausal ages but exceeded 5 percent throughout the period of observation in the oldest age group. An understanding of the biologic basis for the complex relation between age and prognosis might provide a better understanding of the natural history of breast cancer in women.

Adult↗
PubMed1986

Survival in breast cancer diagnosed between mammographic screening examinations.

In women drawn from a randomised, population-based trial of mammography screening for breast cancer the overall actuarial survival and disease-free survival for up to 7 years of observation were similar in 94 patients with interval cancers and 178 control patients with cancer diagnosed independent of screening. The similarity was confirmed by multiple regression analysis. These results contradict the hypothesis that a high growth rate of the primary tumour is associated with a greater metastatic potential and do not support the concept that patients with interval cancers should receive more aggressive local or systemic treatment.

Actuarial Analysis↗
PubMed1986

Absence of therapeutic benefit from antacids or cimetidine in non-ulcer dyspepsia.

We randomly assigned 159 patients with non-ulcer dyspepsia, defined as chronic or recurrent epigastric pain without concomitant symptoms of the irritable bowel syndrome and with no evidence of organic disease, to treatment for three weeks with an antacid suspension one and three hours after meals, 400 mg of cimetidine twice a day, or placebo, according to a double-blind, double-dummy model. The intensity and duration of epigastric pain were recorded by the patients four times daily during a one-week period without therapy and during the three weeks of treatment. The mean reduction in pain intensity after three weeks in the placebo group was 25 percent. Neither antacid nor cimetidine treatment resulted in more than a 4 percent better effect. The reduction of pain was statistically significant (P less than 0.01) in all three groups. The time course of the pain scores in the groups receiving active drugs followed closely those in the placebo group, and there were no significant differences between the groups at any stage of the treatment. We conclude that the neutralization or suppression of gastric acid is of no clinical value in patients with this syndrome.

Adolescent↗
PubMed1986

Clinical results 1-10 years after highly selective vagotomy in 306 patients with prepyloric and duodenal ulcer disease.

Overall clinical results were assessed 1-10 years after routinely performed highly selective vagotomy (HSV) in 326 consecutive patients suffering duodenal and prepyloric ulcer disease, operated on by 37 surgeons of varying seniority at a district general hospital. Three hundred and six (94 per cent) patients were followed up. No mortality was recorded after 326 primary and 50 reoperative procedures. Postoperative complications were few and diminished during the study period. Persistent moderate to severe dumping was found in 2.3 per cent of the patients; slight and periodic, but in no case disabling, diarrhoea in 11 per cent and gastric retention in 2.1 per cent. The overall clinical ulcer recurrence rate was 13.8 per cent, with a tendency towards better results during the second 5 year period. Significant differences were found between individual surgeons and groups of surgeons. Recurrences tended to be located more proximally than the primary ulcer. Fifty reoperations were performed in forty patients for ulcer recurrence (twenty-five), persistent ulcer-like symptoms (twelve) and gastric retention (three). When all recurrences and reoperations were classified as failures the symptomatic assessment according to Visick showed 67 per cent of the patients in grades I-II and 26 per cent in grade IV but the corresponding figures from the patients' own classification including the results of reoperations were 79 per cent and 7 per cent. It is concluded that for the time being HSV is the method of choice for the elective surgical treatment of duodenal and prepyloric ulcer disease.

Adolescent↗