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Biomedical subjects

J J Spinelli

Publications and source records attributed to J J Spinelli.

At least 73 records · Page 4Linked to original sources
PubMed1991

Neurologic complications in allogeneic bone marrow transplant patients receiving cyclosporin.

Regimens using cyclosporin (CSP) and either methylprednisolone (MP) or methotrexate (MTX) have been useful in the prophylaxis of acute graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation (BMT). However, CSP produces a number of side effects, including neurologic toxicity. A retrospective review of recipients of 239 BMTs given CSP-based prophylactic regimens revealed that 10 patients (4.2%, 95% confidence interval 0% to 10.4%) experienced a syndrome characterized by hypertension, severe visual disturbances, seizures and occipital lobe density changes on brain computed tomography (nine patients) or nuclear magnetic resonance imaging (one patient). Neurologic findings were reversible in all cases, usually after temporary discontinuation of CSP. Univariate analysis identified the following risk factors for neurotoxicity: use of unrelated or HLA-mismatched related donors, administration of etoposide (VP-16) or total body irradiation as part of conditioning, use of corticosteroids for prophylaxis or treatment of acute GVHD, or development of either acute GVHD or clinically significant microangiopathic hemolytic anemia (MAHA) post-BMT. In multivariate analysis, the most important predictors were the use of VP-16 (p = 0.008), the use of a continuous infusion CSP plus MP prophylactic regimen for GVHD (p = 0.003) and the development of MAHA after BMT (p less than 0.001). The strong association with MAHA suggests that endothelial damage is related to the development of this complication.

Adolescent↗
PubMed1991

A hierarchical coding system for occupational exposure.

A 10-digit hierarchical method for coding occupationally encountered chemicals offering significant advantages over existing chemical coding systems has been developed and tested. With this unique system, substances are categorized and coded according to their composition and physical natures. Consequently, compounds of similar structure may be distinguished, and classes of similar compounds (for example, all halogenated organic compounds, all inorganic sulfates) can be readily retrieved. This novel coding system was developed to assist primarily in the identification of potential carcinogens in occupational studies using job exposure matrices. However, the system has wider applications as it can be employed by industry to facilitate data management and monitoring programs in the workplace.

Carcinogens↗
PubMed1990

Identification of occupational cancer risks using a population-based cancer registry.

The study of Xuan Wei fuel use and lung cancer mortality and also the interim case-control study suggested an association between domestic smoky coal use and Xuan Wei lung cancer. The collaborative studies of physical characterization, chemical analysis, and toxicology further substantiated this linkage. The Xuan Wei residents who used smoky coal inhaled extremely high concentrations of mostly submicron-sized particles, which can be inhaled and deposited effectively deep in the lung. These fine particles were composed mostly of organic compounds (72%), including mutagenic and carcinogenic organic compounds, especially in the aromatic and polar fractions. These residents were exposed to polycyclic aromatic compounds, such as benzo[a]pyrene, at comparable or higher levels than those measured in coke oven plants and other occupational environments (International Agency for Research on Cancer 1984). In comparison with wood and smokeless coal combustion emissions, the organic extracts of smoky coal emission particles showed much higher activity of genotoxicity and carcinogenicity. These results all point to a strong etiological link between the complex organic mixtures from smoky coal emissions and Xuan Wei lung cancer. This study and studies reported by other investigators (de Koning et al. 1984) suggested little association between indoor open-fire wood smoke and lung cancer. The less efficient lung deposition of the larger particles from wood combustion, as well as the lower concentrations of biologically active organic compounds, may contribute to the low rate of lung cancer in the wood-burning communes. As to the smokeless coal emissions, the lower particulate concentration and the lower organic content of the particles emitted may also contribute to the low lung cancer rate in the commune using this fuel. In conclusion, the complex organic mixtures from combustion emissions are genotoxic and carcinogenic in animal and in vitro assays. The magnitude of the cancer risks from the complex organic mixtures in man depends on the degree of the exposure, the types of the compounds contained in the mixtures, and the concentrations of these biologically active compounds present in the combustion emissions.

Air Pollutants↗
PubMed1990

Anatomic distribution of acquired melanocytic nevi in white children. A comparison with melanoma: the Vancouver Mole Study.

The presence of acquired benign nevi is a risk factor for cutaneous melanoma, yet relatively little is known about the etiology of nevi. We have conducted a study of the prevalence of melanocytic nevi among 1146 white Vancouver (Canada) schoolchildren aged 6 to 18 years. Numbers of nevi per square meter of body surface area increase with age in children of both sexes. Male adolescents have more nevi than female adolescents on the head and neck as well as on the trunk, while prevalence in females is higher on the upper and lower limbs. This distribution parallels that of cutaneous melanoma in British Columbia adults. Nevi are more common in children on intermittently exposed body sites than on constantly or minimally sun-exposed sites. This suggests that exposure to strong intermittent sunlight in childhood (a risk factor for cutaneous melanoma) may also be important in the etiology of acquired benign nevi.

Adolescent↗
PubMed1990

Mortality and cancer incidence in a cohort of commercial airline pilots.

We undertook a cohort study of all male pilots employed since January 1, 1950, by CP Air, now Canadian Airlines International. A total of 913 eligible pilots--630 active and 283 no longer employed--contributing 18,060 person-years of observation, were identified through company records. As of October 31, 1988, current status was obtained on 891 (97.6%). Standardized mortality ratio (SMR) and standardized incidence ratio (SIR) were used to compare, respectively, the mortality and cancer incidence of the cohort with that of the British Columbia population. Statistical significance of the SMR and SIR by comparison with the Poisson distribution (p less than 0.05 one-sided) and 90% confidence intervals (CI) were calculated. Excess deaths were observed for aircraft accidents (No. = 23; SMR = 21.29; p less than 0.001; CI 14.60, 30.20), brain cancer (No. = 4; SMR = 4.17, p = 0.017; CI 1.40, 9.50) and rectal cancer (No. = 3; SMR = 4.35; p = 0.033; CI 1.20, 11.20). Excess cancer incidence was noted for non-melanoma skin cancer (No. = 26; SIR = 1.59; p = 0.017; CI 1.10, 2.20), brain cancer (No. = 4; SIR = 3.45; p = 0.030; CI 1.20, 7.90) and Hodgkin's Disease (No. = 3; SIR = 4.54; p = 0.030; CI 1.20, 11.70). These findings, suggesting an excess risk for certain cancers in commercial airline pilots, are based on small numbers and need to be confirmed in larger cohort studies.

Aerospace Medicine↗
PubMed1990

Suntan, sunburn, and pigmentation factors and the frequency of acquired melanocytic nevi in children. Similarities to melanoma: the Vancouver Mole Study.

The association between prevalence of benign melanocytic nevi and a number of skin cancer risk factors was examined among 913 white Vancouver (Canada) school children aged 6 to 18 years. Subjects with light skin, with a propensity to burn rather than tan in the sun, and with numerous or severe sunburns in the previous 5 years had significantly higher nevus counts than individuals without these characteristics. Subjects who acquired deeper tans tended to have fewer nevi than those who did not tan. Finally, children who freckled had higher nevus counts than those who did not freckle. These findings in children are similar to those seen in studies of malignant melanoma among adults and suggest that strategies to reduce melanoma incidence should begin with young children.

Adolescent↗
PubMed1989

Pathologic prognostic factors for cutaneous malignant melanoma: the Western Canada Melanoma Study.

An analysis of data for histopathologic factors influencing survival was conducted on 798 cases of invasive cutaneous malignant melanoma. On univariate analysis, a number of factors influenced survival; however, when these factors were examined using a proportional-hazards model, sex and log of depth of penetration were the only factors governing survival. Moreover, these factors were only important in patients with lesions up to 4 mm in depth with no evidence of other disease. For patients with solitary lesions deeper than 4 mm, or patients with regional or distant disease, none of the factors examined in our study was of predictive value for survival assessment.

Adult↗
PubMed1988

Survival, response and immune effects in a prospectively randomized study of dose strategy for alpha-N1 interferon.

Several tumour sites have now demonstrated objective responses to alpha interferons in a diversity of doses and schedules. Since effectiveness should be enhanced with the identification of an optimal dose strategy, we undertook a prospectively randomized study to compare an intermittent high dose escalating strategy (HDS) vs. a fixed low dose treatment in relation to clinical outcome and laboratory correlates of immune function. HDS patients received interferon alpha-N1 (lymphoblastoid interferon) 5M units m-2 by continuous i.v. infusion over 24 h, escalating by 5 M units m-2 day-1 as tolerated over 10 days, and repeated every 28 days. The low dose strategy (LDS) consisted of a fixed dose of 2 M units m-2 by intramuscular injection daily for 28 days, then daily for 7 days every other week. There were 53 evaluable patients. In keeping with earlier preliminary results there was evidence of improved immune function for HDS patients. They demonstrated a significant increase in the number of CD2+ (sheep red blood cell binding) cells and CD4+ (helper-inducer/suppressor-inducer) cells along with enhanced activity of natural killer cell, and mixed leukocyte culture activity. In addition to improved immune function, HDS patients survived longer than LDS (P = 0.04). Analysis of survival in relation to response suggested that monitoring of minor responses may be of interest for biological agents such as interferon.

Adult↗
PubMed1987

Oestrogen receptors, nodes and stage as predictors of post-recurrence survival in 457 breast cancer patients.

The relationship to survival after first recurrence of oestrogen receptor (ER), nodal status and TNM stage at diagnosis, and treatment for advanced disease was studied in 457 females whose primary breast cancer was diagnosed in 1975 to 1981. Receptor concentration was the most important predictor of post-recurrence survival, with some additional information conveyed by nodal status. ER predicted survival after recurrence independently of nodal status, clinical stage or mode of therapy. Response to endocrine therapy is only a facet of the generally favourable prognosis of ER positive patients, rather than the sole explanation.

Breast Neoplasms↗
PubMed1987

Socioeconomic status, sunlight exposure, and risk of malignant melanoma: the Western Canada Melanoma Study.

In a study of 261 male melanoma patients and age-and sex-matched controls, a strong positive univariate association between socioeconomic status, as determined by usual occupation, and risk of melanoma was detected. This association, however, was substantially explained by host constitutional factors and occupational, recreational, and vacation sunlight exposure. The study demonstrated an increased risk of melanoma in draftsmen and surveyors and a reduced risk of melanoma in construction workers and individuals employed in the finance, insurance, and real estate industry even after control for the effect of host factors and sunlight exposure.

Canada↗
PubMed1986

Occupation and risk of cutaneous melanoma.

Occupational mortality from cutaneous malignant melanoma was evaluated for deaths occurring in British Columbia from 1950-1978 by using age standardised proportional mortality ratios (PMR). For males, significantly elevated PMRs for melanoma were seen in managers and owners, accountants, architects, chemical engineers, and gardeners and nursery workers. Female school teachers were also at elevated risk of death from cutaneous melanoma.

British Columbia↗
PubMed1985

Reproductive factors, oral contraceptives and risk of malignant melanoma: Western Canada Melanoma Study.

A study of 361 female melanoma patients and age matched controls was conducted in the four western provinces of Canada. Analysis of reproductive factors showed a significant negative association between number of livebirths and risk of melanoma. The relationship persisted for superficial spreading melanomas after adjustment for host pigmentation factors, freckling, and educational status. An inverse association between bilateral oophorectomy and risk of superficial spreading melanoma was also seen. No association was found between risk of melanoma and age at first birth, age at menarche and age at natural menopause. No association was found between risk of superficial spreading or nodular melanoma and use of either oral contraceptives or menopausal oestrogens.

Adult↗
PubMed1985

Cancer mortality experience of woodworkers, loggers, fishermen, farmers, and miners in British Columbia.

To evaluate occupational cancer mortality in British Columbia, we calculated the age-standardized proportional mortality ratios (PMR) and proportional cancer mortality ratios (PCMR) for 4,091 woodworkers, 5,457 loggers, 2,020 fishermen, 4,066 farmers, and 1,912 miners. Woodworkers 20-65 years old had significantly elevated risks of death from stomach cancer (PCMR = 128, P less than .01) and non-Hodgkin's lymphoma (PCMR = 140, P less than .05). Loggers appear to have an elevated risk of death from nasal sinus tumors (PCMR = 364, P less than .05). Fishermen had an elevated risk of stomach cancer (PCMR = 168, P less than .01). Farmers in British Columbia appeared to have excess risks of stomach (PCMR = 136, P less than .01) and liver cancer (PCMR = 173, P less than .05), but decreased risk from lung cancer (PCMR = 76, P less than .01). Miners had an elevated risk of death from lung cancer (PCMR = 127, P less than .05) and primary eye tumors (PCMR = 569, P less than .05).

Adult↗