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Biomedical subjects

J Cuzick

Publications and source records attributed to J Cuzick.

At least 181 records · Page 10Linked to original sources
PubMed1983

A prospective study of urinary androgen levels and ovarian cancer.

The three major urinary androgen metabolites, dehydroepiandrosterone (DHEA), androsterone (ANDRO), and aetiocholanolone (AETIO) were measured in 1,484 volunteer women between 29 and 60 years of age on the island of Guernsey from 1962-1967. Twelve of these women subsequently developed ovarian cancer after a median interval of 130 months and a minimum interval of 19 months. All three androgen levels in these women were lower than those in controls matched for age and menopausal status. The results were most striking for DHEA, where half of the cases were below the 27th percentile of their matched controls (p = 0.007, two-sided). The results for ANDRO were of marginal significance (p = 0.06), and those for AETIO were not significant (p = 0.33).

Adult↗
PubMed1983

International variations and temporal trends in mortality from multiple myeloma.

Mortality statistics for multiple myeloma over the period 1960-1975 have been analysed for 23 countries. Attention has been focused on international variations, secular trends, and the male to female mortality ratio. The greatest percentage increases have been found in countries with low overall rates. The male:female ratio was generally higher in countries with high rates, and the national rates correlated more strongly with GNP per caput than with an index of medical care (hospital beds/10,000). Further analyses have been carried out over the period 1955-79 in Sweden, a country with high but relatively stable rates, and Japan, where the rates are very low but are increasing rapidly. An age, period, and cohort analysis of the trends in these countries is presented and criticized. The contributions made by increased diagnostic capability and by an increase in the true incidence of the disease are discussed.

Adult↗
PubMed1983

Daily patterns of asthma in New York City and New Orleans: an epidemiologic investigation.

Examination of records of daily visits to emergency rooms for asthma covering 25 years from New Orleans and 9 years from New York City reveals a distinct day-of-the-week pattern in New York City whereas no such pattern is discernible in New Orleans. The difference in daily patterns of asthma attacks in the populations from the two cities strongly suggests a different environmental etiologic agent acting on these two populations. It is proposed herein that in New York susceptible individuals are exposed to some agents or factors triggering attacks which are present in the home environment where most of their time is spent on weekends, while in New Orleans, homes are not as sealed off from the outside air, because of the warmer climate, so that the agent triggering attacks is as common outdoors as indoors, and thus there is little difference between weekend and weekday exposure.

Adult↗
PubMed1983

Prognostic factors in non-Hodgkin's lymphoma: the importance of symptomatic stage as an adjunct to the Kiel histopathological classification.

A prospective study of prognostic factors for patients with non-Hodgkin's lymphoma was carried out based on the Kiel histopathological classification. Other presentation features assessed for prognostic value included clinical features, haematological and biochemical findings, and immunochemical findings. The most powerful factors that emerged were the presence or absence of systemic symptoms and the histopathological grade of malignancy of the lymphoma (whether low or high grade). These 2 factors were largely independent. Clinical Stage I disease also carried a good prognosis, but beyond this, staging gave little further prognostic information. Nine of the group of 15 patients with Stage I high grade lymphoma have achieved prolonged disease-free survival after local therapy only. After allowing for histopathology and symptom assessment in patients with Stage II-IV disease, other factors, with the exception of C-reactive protein levels, were of minor importance.

Adult↗
PubMed1982

Medicinal arsenic and internal malignancies.

A mortality analysis has been carried out on a cohort of patients given Fowler's solution (potassium arsenite) for periods ranging from 2 weeks to 12 years between 1945 and 1969. An excess of fatal and non-fatal skin cancer was apparent, but there was no overall excess mortality from cancer. Further analyses by site of cancer, dose level, and time from first exposure are also presented. A subset of patients were examined in 1969-70 for the presence of arsenical keratoses, hyperpigmentation and skin cancer. About half the patients had one or more of these signs. Although the cancer mortality of this entire subgroup was similar to the expected value, all the cancer deaths occurred in patients with prior signs of arsenicism. These data suggest that while any excess of internal malignancy due to the use of Fowler's solution is small or non-existent, there may be a susceptible subgroup which can be identified from dermatological manifestations.

Adult↗
PubMed1982

Long-term survival in myelomatosis. A report to the MRC working party on leukaemia in adults.

The patients entered into the Medical Research Council's First Myelomatosis Trial (MRCI) have been followed up for a minimum of 12 years, and an attempt has been made to define features recorded at presentation that might predict long-term survival and to estimate the risk of acute myeloid leukaemia (AML) induced by treatment with either of the alkylating agents, melphalan or cyclophosphamide. In this series, the chance of a patient surviving 5 years was strongly related to the haemoglobin, blood urea concentration (BUC) and performance status at presentation. Other features, including paraprotein levels, type of heavy or light chain, bone lesions and recovery of polyclonal immunoglobulin added little useful information. Six patients died of AML, all after more than 4 years in the trial; the incidence of AML among 4-year survivors was 10%. All six patients had been treated with continuous melphalan and the implications of this for future chemotherapy for myelomatosis are discussed.

Aged↗
PubMed1982

Increasing trends of multiple myeloma mortality in England and Wales; 1950-79: are the changes real?

National statistics for England and Wales for the period of 1950-79 were examined to study the secular trends in multiple myeloma mortality and to evaluate the extent to which these changes may be due to biases associated with improvements in medical care. Age-adjusted mortality has increased more than fivefold during this 30-year period. Contrary to the impression obtained from clinical series, a slightly greater increase in age-adjusted mortality has occurred in males. Examination of age- and sex-specific mortality trends showed that the greatest apparent increase in myeloma mortality occurred in individuals over 70 years of age. The data are consistent with either a cohort effect, indicating a true increase in mortality, or an age-dependent diagnostic effect in which a greater percentage of deaths among the elderly are now being certified as myeloma. Analyses of mortality data by social class and region point toward improved case ascertainment being responsible for at least part of the apparent increase in reported mortality. The increase in reported mortality in the younger age groups may reflect a true increase in the incidence of this disease. This increase, however, would account for only a proportion of the total increase, even when extrapolated to the older age groups.

Adult↗
PubMed1981

Radiation-induced myelomatosis.

It is well known that radiation can cause myeloid leukemia. However, no excess of chronic lymphocytic leukemia has been observed. Myelomatosis, like chronic lymphocytic leukemia, is a tumor of B lymphocytes. To determine whether this disease has a radiogenic origin, we surveyed all cohorts of persons exposed to radiation for which data on cancer-related mortality are available. An excess of myeloma was found in most cohorts. However, a striking deficit was found in two groups irradiated intensely for uterine neoplasms (three cases observed, 10.71 expected; P = 0.012). All other groups combined had a highly significant excess (50 observed, 22.21 expected; P = 2 X 10(-7)). The largest relative risk appeared among persons receiving internal doses of alpha-particles (14 observed, 3.24 expected; P = 2 X 10(-5)), but a significant excess (13 observed, 6.33 expected; P = 0.026) was also found in patients receiving only therapeutic or diagnostic gamma-rays or x-rays. Most cases occurred 15 to 25 years after exposure.

England↗
PubMed1981

A prospective study of plasma prolactin levels and subsequent risk of breast cancer.

Plasma prolactin was measured in 2,572 pre-menopausal, 628 menopausal, and 1,666 peri- and post-menopausal women who were apparently healthy. Breast cancer was subsequently diagnosed in 47 of these women at a median time of 5 years after blood collection (pre-cancer cases). Prolactin levels in pre-menopausal cases increased significantly with age whereas this was not found in matched controls. The perimenopausal cases were characterized by extreme variability in prolactin levels. In post-menopausal women who developed breast cancer, the prolactin levels were significantly elevated, being at or above the 70th percentile for the controls. In this group the results are consistent with prolactin acting as a late-stage tumour promoter.

Adult↗
PubMed1981

Application of a time-space clustering methodology to the assessment of acute environmental effects on respiratory illnesses.

A new methodology is proposed for the identification of environmental events of health significance. Health indices measured on a daily basis at various location in a single geographical area are collected over time. First, the daily variations are examined to determine whether they reflect purely random variations or whether there are days on which there are extreme variations not plausibly explicable as random events. After such days are identified, the question of whether they occur only at a single location within the larger geographical area at one time, or whether the occur simultaneously at more than one location is investigated. Tests of statistical significance for both temporal and spatial clustering are propose. The methodology is applied to daily hospital emergency room visits for various respiratory complaints to several New York City hospitals situated in two geographically separated districts which however have population of similar socio-economic and ethnic composition.

Air Pollution↗
PubMed1979

Light chain isotype-associated suppression of normal plasma cell numbers in patients with multiple myeloma: Medical Research Council's Working Party for Leukaemia in Adults and the Oxford Lymphoma Group.

The number of plasma cells in the lamina propria of the gut has been assessed in patients with multiple myeloma and other B-cell neoplasms. The total number of these plasma cells was reduced in most patients with myelomatosis and one-third of patients with lymphoplasmacytoid tumours. This reduction was not, however, seen in patients with other neoplasms of B-cell origin, although hypogammaglobulinaemia was common to all groups of patients. The depletion of gut plasma cell numbers was not uniform in myelomatosis patients. They showed selective loss of plasma cells with the same light chain isotype as that produced by the neoplastic clone.

Cell Count↗
PubMedDate not supplied

A Wilcoxon-type test for trend.

An extension of the Wilcoxon rank-sum test is developed to handle the situation in which a variable is measured for individuals in three or more (ordered) groups and a non-parametric test for trend across these groups is desired. The uses of the test are illustrated by two examples from cancer research.

Analysis of Variance↗