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Biomedical subjects

J R Daling

Publications and source records attributed to J R Daling.

At least 145 records · Page 8Linked to original sources
PubMed1993

Induction of labor and risk of sudden infant death syndrome.

OBJECTIVE: To investigate whether induction of labor is related to the occurrence of sudden infant death syndrome (SIDS) using a population-based, case-control study. METHODS: Cases comprised infants born between 1984-1988 in Washington state who died of SIDS according to their death certificate (ICD-9-CM 798.0) (N = 728). For comparison, we randomly selected a group of infants born in these same years who did not die of SIDS (N = 3021). Information regarding the pregnancy, labor, delivery, and condition of the newborn was obtained from the infants' birth certificates. RESULTS: Among the indications for induction that were examined, we found a slightly elevated risk of SIDS associated with advanced gestational age (greater than 41 completed menstrual weeks) (odds ratio [OR] 1.3, 95% confidence interval [CI] 1.0-1.8). A similar proportion of cases and controls had induced labors (OR 1.2, 95% CI 0.7-2.1). Although there was little or no apparent risk associated with induction among infants who had term gestations (37-41 completed menstrual weeks; OR 1.2, 95% CI 0.6-2.2), an increased risk was found among infants who had gestations of 42 weeks or greater (OR 3.0, 95% CI 0.7-12.5). We did not observe this trend with augmentation of labor. CONCLUSION: Our findings do not support an overall association between the methods used for induction of labor in the United States and the occurrence of SIDS. The elevated risk of SIDS observed in relation to induction of labor among infants who had post-term gestations raises the possibility that infants who do not spontaneously initiate labor may suffer some neuroregulatory or other abnormality involved in the pathogenesis of SIDS.

Adult↗
PubMed1993

Vaginal douching as a risk factor for acute pelvic inflammatory disease.

OBJECTIVE: To conduct a population-based evaluation of vaginal douching as a risk factor for acute pelvic inflammatory disease (PID), emphasizing timing, frequency, and reasons for douching. METHODS: A population-based case-control study was conducted at Group Health Cooperative of Puget Sound, a staff-model health maintenance organization located in western Washington state. The cases (N = 131) were women 18-40 years of age who experienced a first episode of clinically diagnosed acute PID. Both hospitalized and ambulatory-care patients were identified. Medical records were reviewed for clinical inclusion criteria and for additional evidence of inflammation/infection. Controls (N = 294) were chosen from a population-based series of randomly selected women from a concurrent Group Health study of ectopic pregnancy. Of the women identified, 72.4% of cases and 73.4% of controls agreed to participate. RESULTS: Relative to women who reported never having douched, women who douched during the previous 3 months had a risk of PID of 2.1 after controlling for other measured risk factors (95% confidence interval [CI] 1.2-3.9). Women who douched at least once a week had a higher estimated risk (odds ratio 3.9, 95% CI 1.4-10.9) than those who douched less often (odds ratio 1.8, 95% CI 1.0-3.4). The risk was highest in the small group of women who gave infection as the reason for douching (odds ratio 7.9, 95% CI 2.6-24.2). However, exclusion of this group did not eliminate the association among the remaining women (odds ratio 3.0, 95% CI 1.0-9.1 for douching at least once a week). CONCLUSION: These population-based data lend added support to the hypothesis that vaginal douching can predispose a woman to PID.

Acute Disease↗
PubMed1992

Association of prior infection with Chlamydia pneumoniae and angiographically demonstrated coronary artery disease.

OBJECTIVE: To evaluate the association between prior infection with Chlamydia pneumoniae, as measured by IgG antibody, and coronary artery disease. DESIGN: A population-based, case-control study. SETTING: Group Health Cooperative of Puget Sound, a Seattle-based health maintenance organization. PARTICIPANTS: Men 55 years of age and younger and women 65 years of age and younger. Cases (n = 171) were members of Group Health Cooperative undergoing diagnostic coronary angiography who had at least one coronary artery lesion occupying 50% or more of the luminal diameter. The population controls (n = 120) were Group Health Cooperative members without known coronary heart disease. MAIN OUTCOME MEASURE: The adjusted odds ratio (OR) for coronary artery disease associated with prior C pneumoniae infection as measured by the presence of IgG antibody. RESULTS: After adjusting for age, gender, and calendar quarter of blood drawing, the OR for coronary artery disease associated with the presence of antibody was 2.6 (95% confidence interval, 1.4 to 4.8). The association was limited to cigarette smokers, in whom the OR was 3.5 (95% confidence interval, 1.7 to 7.0). Among never-smokers, the OR was 0.8 (95% confidence interval, 0.3 to 1.9). When cases and controls were restricted to those assayed concurrently, the adjusted OR (smokers and nonsmokers combined) was 4.2 (95% confidence interval, 1.8 to 10.0). Adjustment for serum cholesterol, hypertension, alcohol use, diabetes, and socioeconomic status did not change these results. Only a week association was found when cases were compared with 63 subjects whose angiographic results were normal (OR, 1.2; 95% confidence interval, 0.6 to 2.2). CONCLUSIONS: These results generally support the previously reported association between C pneumoniae infection and coronary heart disease. However, caution should be used in interpreting the basis for this association.

Adult↗
PubMed1992

Human papillomaviruses, herpes simplex viruses, and the risk of oral cancer in men.

A population-based case-control study was conducted in western Washington state to examine the relations between infection with human papilloma viruses (HPV), herpes simplex viruses (HSV), and risk of oral squamous cell cancer in men. Interviews were completed on 131 oral cancer cases diagnosed between January 1985 and December 1989 and 136 controls frequency matched to cases on age and date of diagnosis who were obtained by random digit dialing. The risk for oral cancer among men with 30 or more sexual partners was 2.4 times that of men with four or fewer partners (95% confidence interval (CI) 1.0-5.9). Men who ever practiced oral sex had lower risk for oral cancer relative to men who never practiced oral sex (relative risk (RR) = 0.4, 95% CI 0.2-0.8). Analyses of exfoliated oral cavity cells for the presence of HPV-6 DNA with polymerase chain reaction revealed that men with an oral HPV-6 infection had 2.9 times the risk for oral cancer of noninfected men (95% CI 1.1-7.3), whereas men with an oral HPV-16 infection had 6.2 times the risk for oral cancer of noninfected men (crude RR = 6.2, 95% CI 0.7-52.2). Relative risks associated with serologically detected HSV-1 and HSV-2 infections were 0.8 (95% CI 0.3-1.7) and 1.8 (95% CI 0.7-4.6), respectively. The authors conclude that HPV-6 is associated with oral cancer. Although men infected with HPV-16 and HSV-2 were at elevated risk, these associations may have been due to chance. The role of specific sexual practices in the transmission of viruses to the oral cavity remains unclear.

Antibodies, Viral↗
PubMed1992

Cigarette smoking and the risk of anogenital cancer.

The association between cigarette smoking and cervical cancer has been demonstrated in numerous prior studies. As part of population-based case-control studies of cancers of the vulva, vagina, cervix, anus, and penis in relation to infection with human papillomavirus, conducted in western Washington State and the province of British Columbia from the mid 1980s until the present time, the authors have collected detailed information on smoking history. The proportion of subjects who were current smokers of cigarettes ranged from slightly over 40% among incident cases of vaginal and cervical cancer to 60% among cases of vulvar and anal cancer. In contrast, only about 25% of controls were current smokers. The adjusted odds ratios (OR) associated with current smoking were substantially elevated (OR = 1.9-14.6) for all cancer sites except cancer of the vagina (OR = 1.3). The risks tended to increase in proportion to the number of cigarettes smoked. For most cancer sites, the odds ratios associated with former smoking were substantially less than those associated with current smoking and diminished with increasing time since cessation of smoking. The authors' data and those of other investigators suggest that cigarette smoking plays a role in the etiology of anogenital cancers and that smoking has a late-stage or promotional effect.

Adolescent↗
PubMed1992

Noncontraceptive hormone use and risk of breast cancer.

All British Columbia (Canada) women under 75 years of age who were diagnosed with breast cancer during 1988-89 were asked to complete a postal questionnaire which included detailed information on menopausal estrogen use. Controls were drawn from the Provincial Voters List, matched by five-year age category to the cases. The present analysis consists of 699 cases and 685 controls who were postmenopausal due to natural causes or to a hysterectomy. There was no overall increase in risk of breast cancer associated with ever-use of unopposed estrogen (odds ratio [OR] = 1.0, 95 percent confidence interval [CI] = 0.8-1.3). For estrogen use of 10 years or longer, the relative risk [RR] was 1.6 (CI = 1.1-2.5). The risk estimate for current users was somewhat elevated (OR = 1.4, CI = 1.0-2.0). Compared with women who never used hormone preparations, women who had used estrogen plus progestogen had an RR of 1.2 (CI = 0.6-2.2). Our results suggest that ever-use of estrogen, with or without progestogen, does not appreciably increase the risk of breast cancer. However, long-term and recent use of unopposed estrogen may be associated with a moderately increased risk.

Aged↗
PubMed1992

Prevalence and determinants of caesarean section in Jamaica.

The prevalence and determinants of primary caesarean section in Jamaica were estimated from a survey of women aged 14-49 years. Among 2328 women reporting 2395 live hospital births during the period January 1984 to May 1989, the prevalence of caesarean section was 4.1%. Repeat caesarean sections accounted for 1.3% of the hospital births during that period. Of the medical complications studied, prolonged labour and/or cephalopelvic disproportion carried the highest risks of primary caesarean section, followed by breech presentation, maternal diabetes, a high birth-weight baby, maternal hypertension, and a low birth-weight baby. The risk of primary caesarean section increased with maternal age, decreased with parity, was higher for urban than for rural residents, and was higher for births in private versus government hospitals.

Adolescent↗
PubMed1992

Current cigarette smoking and risk of acute pelvic inflammatory disease.

OBJECTIVES: Further information is needed on modifiable factors associated with the occurrence of acute pelvic inflammatory disease (PID). Cigarette smoking has been implicated as a risk factor for PID sequelae, but the association between smoking and PID has yet to be fully examined. METHODS: We conducted a population-based case-control study to evaluate smoking as a risk factor for acute PID. The case patients (n = 131) were women health maintenance organization (HMO) enrollees between the ages of 18 and 40 years who were treated for a first episode of PID. The control patients (n = 294) were randomly selected from the HMO enrollment files. RESULTS: Relative to never smokers, current smokers were at increased risk of PID. Women who smoked 10 or more cigarettes per day had a higher risk than did those who smoked less. Available data indicate that smoking status is not serving as a marker for uncontrolled confounding by lifestyle factors. CONCLUSIONS: Our study results suggest that smoking represents a modifiable risk factor for acute PID.

Adolescent↗
PubMed1992

Low birth weight in relation to multiple induced abortions.

BACKGROUND: Most studies report that a single induced abortion does not increase risk for delivering a low birth weight infant in a subsequent pregnancy. However, the effect of multiple abortions has not been adequately evaluated. METHODS: This relationship was studied in 6541 White women who delivered their first child between 1984 and 1987. We compared the frequencies of low birth weight (less than 2500 g) among infants born to 1999 women without prior induced abortion and 1999 women with one abortion with the frequencies of low birth weight among infants born to women with two (n = 1850), three (n = 520), and four or more (n = 173) prior induced abortions. RESULTS: After adjustment for confounding variables, we found no linear relationship in risk of low birth weight among women with one (relative risk [RR] = 1.2, 95% confidence interval [CI] = 0.9-1.5), two (RR = 1.5, 95% CI = 1.1-2.0), three (RR = 1.3, 95% CI = 0.8-1.9), or four or more (RR = 1.6, 95% CI = 0.9-2.9) prior induced abortions. CONCLUSIONS: These findings confirm earlier reports of little or no evidence of harmful effects on birth weight by one or by two or more induced abortions. We further report that risk is not significantly elevated even in women with three, four, or more prior terminations of pregnancy when compared with women with one or two abortions.

Abortion, Induced↗
PubMed1992

Association of human immunodeficiency virus and anal human papillomavirus infection among homosexual men.

BACKGROUND: A previous study of men with proctitis, proctocolitis, or enteritis showed an association of anal human papillomavirus (HPV) infection with human immunodeficiency virus (HIV) infection. Because anorectal abnormalities may confound an observed association between anal HPV DNA and HIV seropositivity, the present study was undertaken among consecutive homosexual men seeking HIV serologic testing who were unselected for anorectal symptoms. METHODS: Consecutive homosexual men underwent a standardized interview, physical examination, and collection of specimens for HIV serologic testing and detection of anal HPV DNA. RESULTS: Anal HPV DNA was detected in eight (31%) of 26 HIV-seropositive men and in 10 (8%) of 119 HIV-seronegative men (odds ratio, 5.8; 95% confidence interval, 1.1 to 30.1, adjusted for history of sexually transmitted disease, current anorectal symptoms, and age). When men with anorectal symptoms were excluded from the analysis, anal HPV DNA was detected in 27% of seropositive men compared with 8% of seronegative men (odds ratio, 4.4; 95% confidence interval, 1.4 to 13.4). There was no difference between HIV-seropositive and HIV-seronegative men with respect to distribution of type of HPV DNA. Men with group II or III and group IV HIV disease were 4.1 and 10.9 times, respectively, more likely than HIV-seronegative men to have anal HPV DNA detected. CONCLUSIONS: Because HIV-seropositive men appear to be at increased risk for the detection of anal HPV DNA, the natural course of anal HPV infection should be compared among HIV-seropositive and HIV-seronegative homosexual men.

Anus Diseases↗
PubMed1992

Relationship between human papillomavirus infection and tumours of anogenital sites other than the cervix.

Although tissues in the case series of anal, penile, vaginal and vulvar neoplasms that have looked for evidence of HPV infection by probing for HPV DNA have been selected for convenience, they support the view that HPV, especially type 16, is associated with approximately 50% of these tumours. A higher percentage of the anal, vaginal and vulvar tumours are associated with HPV 16 than are penile tumours. This discrepancy may be due to the low number of penile tumours studied or to a true difference in the proportion of penile cancer cases related to HPV. HPV 6/11 and 18 are found less frequently at all anatomic sites. About 10% of tumours that are probed for these viruses are positive, although there are some notable exceptions such as a study that found 39% of penile tumours positive for type 18 and a study that found approximately two thirds of vulvar tumours positive for HPV 18 using Southern blot hybridization. For all of these tumours, there is likely to be a subset of the cases who develop their cancer through mechanisms that do not involve HPV. The case-control studies found a strong association with genital warts, number of sexual partners and, with the exception of vaginal cancer, smoking and/or heavy smoking at the time of diagnosis of the disease. A history of genital warts, smoking at diagnosis, and seropositivity to HSV2 are exposures that have also been found to be associated with cervical cancer. A population-based case-control study in western Washington and Vancouver, British Columbia that studied all anogenital cancers found that a history of genital warts was stronger among patients with vulvar, anal, vaginal and penile cancer than among those with cervical cancer. This was also true of smoking at diagnosis, with the exception of vaginal cancer, where there was little excess risk. This study and other supporting data indicate that these anogenital tumours share many of the same risk factors as cervical cancer.

Anus Neoplasms↗
PubMed1992

Functional ovarian cysts in relation to the use of monophasic and triphasic oral contraceptives.

This population-based case-control study assessed the effect of current use of monophasic or triphasic oral contraceptives (OCs) on the risk of functional ovarian cyst development. The cases were all 15-39-year-old enrollees in the Group Health Cooperative of Puget Sound who had either an inpatient primary diagnosis of functional ovarian cyst in 1988 or 1989 (N = 67) or an outpatient primary diagnosis of functional ovarian cyst from March 1988 through August 1989 at one of five Group Health Cooperative primary care clinics (N = 39). Controls were randomly selected enrollees matched to the cases for age, primary care clinic, and enrollment date (N = 255). Subjects with previous hysterectomy or oophorectomy were excluded from this analysis. Pharmacy and medical record review showed that 16% of cases and 19% of controls were currently using monophasic OCs, whereas 11% of cases and 9% of controls were using triphasic OCs. Compared with women not using hormonal contraception, the relative risks of a diagnosed functional ovarian cyst among women currently using OCs were 0.8 (95% confidence interval [CI] 0.4-1.8) for users of monophasic OCs and 1.3 (95% CI 0.5-3.3) for users of triphasic OCs. In contrast to previous studies of monophasic OCs containing higher steroid dosages, the results of this study suggest that current use of low-dose monophasic OCs does not substantially decrease a woman's risk of functional ovarian cyst formation. In addition, our results do not support recent speculation that current use of triphasic OCs appreciably increases the risk of functional ovarian cysts.

Adult↗
PubMed1992

Pregnancy outcome in women with rheumatoid arthritis before disease onset.

Pregnancy outcome before disease onset was evaluated for women with rheumatoid arthritis (RA) and control women as part of a prospective case-control study of newly diagnosed RA. An analysis of women who were ever gravid revealed no statistically significant difference in any adverse pregnancy outcome between RA cases (n = 144) and controls (n = 605) including spontaneous abortions and stillbirths. Thus, in contrast to reports both of an increase of adverse pregnancy outcomes and a decrease in women who subsequently develop RA, we found no evidence for any difference in pregnancy outcome in the RA group.

Abortion, Spontaneous↗
PubMed1992

Analysis of facial shape in children gestationally exposed to marijuana, alcohol, and/or cocaine.

The association between fetal marijuana and/or alcohol exposure and facial features resembling fetal alcohol syndrome was investigated in a sample of 80 children. Standardized lateral and frontal facial photographs were taken of 40 children, 5 to 7 years of age, whose mothers reported frequent use of marijuana during the first trimester of pregnancy and 40 children whose mothers reported no use of marijuana during pregnancy. The marijuana-exposed and unexposed children were group-matched on alcohol exposure prior to and during pregnancy, sex, race, and age at the time of assessment. The photographs were assessed clinically by a study staff dysmorphologist and morphometrically by computerized landmark analysis. Fetal alcohol syndrome-like facial features were not associated with prenatal marijuana exposure in this study sample. No consistent patterns of facial features were identified among the marijuana-exposed group. Maternal consumption of two or more ounces of alcohol per day, on average, in early gestation was found to be associated with fetal alcohol syndrome-like facial features identified both clinically and morphometrically. Cocaine use reported by 13 of the 80 women was independently associated with mild facial dysmorphic features of hypertelorism and midfacial flattening. The results demonstrate the usefulness of this diagnostic technique for quantifying anomalies apparently unique to fetal alcohol syndrome and for targeting clusters of anomalies in new conditions for future evaluation.

Alcohol Drinking↗