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Biomedical subjects

J R Marshall

Publications and source records attributed to J R Marshall.

At least 19 recordsLinked to original sources
PubMed1992

Alcohol consumption and lung cancer in white males.

Experimental and epidemiologic investigations in alcoholic and nonalcoholic populations have suggested a role of alcohol in lung carcinogenesis. The association between alcohol consumption and lung cancer was investigated among 280 White males with histologically confirmed, primary lung cancer and 564 White male controls, participants in the Western New York Diet Study (United States). Among heavy smokers (over 40 pack-years), total alcohol consumption was associated with an increased risk of lung cancer with adjustment for age, years of education, pack-years of cigarette smoking, and intake of carotenoids and fat. In this group, the odds ratio for drinkers of more than 24 drinks per month was 1.6 compared with those who drank less. Drinkers of more than 12 beers per month were 1.6 times more likely to develop lung cancer than nondrinkers of beer after controlling for age, years of education, and cigarette smoking (95 percent confidence interval = 1.0-2.4, P for trend = 0.003). Occupational and dietary factors did not seem to explain these findings. Although cigarette smoking is the major cause of lung cancer, the role of alcohol, independent or in interaction with cigarette smoking, deserves further investigation.

Adult↗
PubMed1992

Additional ecological evidence: lipids and breast cancer mortality among women aged 55 and over in China.

That dietary fat increases breast cancer risk has been strongly supported by international data collected among developed countries during the past few decades. Population aggregates with elevated lipid intake have tended to report elevated breast cancer incidence and mortality. This study is an ecological analysis of the association of various indicators of lipid intake with breast cancer mortality in 65 county-wide population aggregates in the People's Republic of China. Although the result is consistent with a positive association between lipid intake and breast cancer risk, the observed association is weaker than the association previously observed. This finding provides only modest support for the possibility of a diet-breast cancer link.

Aged↗
PubMed1992

Smoking, alcohol, dentition and diet in the epidemiology of oral cancer.

This matched case-control study was conducted in Western New York. The smoking, alcohol consumption, dental hygiene and diet of 290 cases were compared with those of 290 sex-, age-, and neighbourhood-matched controls. The results confirm earlier findings that cigarette smoking and alcohol consumption impart substantial risk of oral cancer. The results also confirm that poor oral hygiene increases the risk of oral cancer, although this effect is much smaller than those of cigarette smoking and alcohol consumption. The results suggest that, of macronutrients, intake of fat is more likely than those of protein or carbohydrate to be related to risk. Of micronutrients, calcium, sodium, riboflavin and retinol are associated with risk, while thiamin, niacin, and dietary fibre are associated with decreased risk. Although patterns of dietary effects are discernable, these effects are in general much weaker than are those of smoking and alcohol consumption.

Aged↗
PubMed1992

Diet, smoking, and alcohol in cancer of the larynx: a case-control study.

A case-control study among white men in western New York was conducted from 1975 through 1985 to examine diet and other risk factors for laryngeal cancer. Incident pathologically confirmed cases (250) and age- and neighborhood-matched controls (250) were interviewed to determine usual diet and lifetime use of tobacco and alcohol. Cigarettes were strongly associated with risk; pipes and cigars were not. Beer and hard liquor but not wine were associated with increased risk. Dietary fat and carotenoids were related to risk in opposite ways. The upper quartile odds ratio for dietary fat was 2.40 [95% confidence interval 1.26, 4.55], and the upper quartile odds ratio for carotenoids was 0.51 (0.26, 1.01). There was effect modification by smoking. Carotenoids were most negatively associated with risk among the lightest smokers, whereas dietary fat was most positively associated with risk among the heaviest smokers. Total calories, protein, and retinol were associated with increased risk; there was no relationship between laryngeal cancer and vitamin C, vitamin E, carbohydrate, or dietary fiber. This study again demonstrates the strong association between tobacco and alcohol and laryngeal cancer and also suggests that diets low in carotenoids and high in fat may increase risk.

Aged↗
PubMed1992

Dietary patterns and colon cancer in western New York.

Seven dietary patterns were identified among control subjects in the Western New York Diet Study (1975-1986) by application of principal components analysis to data from a 95-item food frequency interview. The results of case-control analyses of colon cancer risk for these patterns are presented. Cases were matched with neighborhood controls on the bases of age and sex; 205 colon case-control male and 223 female pairs were obtained. The dietary patterns and intakes of energy, total fat, and dietary fiber were examined with logistic regression for their individual contributions to risk. In males, three of these dietary patterns were associated positively with fat and energy consumption; they elevated risk for colon cancer and accounted for more risk than did the specific nutrients. Control for energy and fat intakes allowed the protective influences of additional dietary patterns to be expressed. No patterns elevated risk in women; two patterns were protective for colon cancer. Controlling for energy and fat intake enhanced the protection afforded by one of these patterns but had no influence on that of the other. Measures of foods rather than single nutrients may be more inclusive of dietary exposures to risk as well as being related more directly to underlying health behaviors. Therefore they may be better able to account for risk in diseases with multiple causation.

Case-Control Studies↗
PubMed1992

The psychopharmacology of social phobia.

The use of psychotropic drugs in the treatment of social phobia has occurred only recently. The author reviews the available studies which suggest that medications in the beta-blocker group, the monoamine oxidase inhibitors, the benzodiazepines, and possibly others are useful in the treatment of social phobia.

Adrenergic beta-Antagonists↗
PubMed1991

Social phobia. Helping patients who are disabled by fear.

Persistent fear of embarrassment or humiliation in social situations can paralyze a person's educational and career advancement and lead to loneliness and isolation. What are the clinical signs of social phobia? How does it lead to disability and impairment? Dr Marshall answers these questions and discusses differential diagnosis and management.

Behavior Therapy↗
PubMed1991

Patterns in food use and compliance with NCI dietary guidelines.

We developed multidimensional measures of diet by identifying seven gender-specific patterns among 1,475 male and 780 female subjects selected as neighborhood controls in a case-control study of cancer at various sites. The purpose of this study was to examine these patterns for compliance with the National Cancer Institute (NCI) Dietary Guidelines. Diets were scored and each subject assigned tertile ranks for each pattern. Mean values for indicators of compliance were compared across tertiles for each pattern. No one pattern signified compliance with all guidelines. High-fat patterns in both genders and the low-cost pattern in women were the best indicators of poor compliance with NCI guidelines.

Alcohol Drinking↗
PubMed1991

High-risk health behaviors associated with various dietary patterns.

We have previously identified dietary patterns among 1,475 male and 780 female normal healthy control subjects in a case-control study of cancer at various sites. In this paper we examine the presence, among persons exhibiting these dietary patterns, of individual health behaviors that may contribute to risks for cancer. Specifically we examine trimming of separable fat from meats, fats used in cooking and as additions to foods, alcohol consumption, and smoking. Results indicate that men and women differ in possession of these high-risk behaviors. Women are more likely to trim fat from meat, consume less alcohol, and have lower exposures to smoking. Their dietary patterns are more independent of the fats used. Several eating patterns are positively associated with total fat intake but differ in their associations with high-risk behaviors. These data suggest that assessing risk associated with dietary patterns sheds more light on disease relationships than studies of single nutrients.

Aged↗
PubMed1991

Relevance of major stress events as an indicator of disease activity prevalence in inflammatory bowel disease.

The impact of psychological stress in recurrence of inflammatory bowel disease (IBD) is unclear. Why some patients with ulcerative colitis (UC) or Crohn's disease (CD) have unrelenting relapses whereas other IBD patients experience long periods of quiescent disease remains an enigma. The authors examined the risk of exposure to major stress events in clinical episodes of IBD. They followed up on 124 persons in a prospective study that monitored behavioral and biological characteristics for a period of 6 months. Stress-exposed subjects demonstrated increased risk of clinical episodes of disease when compared with unexposed subjects (RR = 2.6, 95% CI: 1.3-4.9). Elevated effect measures were highest for the domain of health-related stress (RR = 3.8, 95% CI: 1.5-9.9). In the multiple regression analysis, major stress events remained the most significant indicator of disease activity in the presence of the covariables considered. Only 7% of the variation in disease activity was uniquely attributed to stress. Baseline activity was the other notable indicator of subsequent disease activity in the study sample. All variables considered together explained 52% of the variance observed and implicated factors of potential clinical importance in monitoring recurrence of the disease.

Adult↗
PubMed1991

Folate intake and carcinogenesis of the colon and rectum.

Experimental evidence suggests that folate depletion plays a role in carcinogenesis. A case-control study examining folate intake was conducted. Some 428 colon and 372 rectal cancer cases with matched neighbourhood controls were interviewed regarding usual intake of foods, including food preparation. Unadjusted folate was not associated with risk of either cancer. Controlling for kilocalories, odds ratios (ORs) for those with the highest folate intake were 0.5 (95% confidence interval (CI): 0.24-1.03) and 0.31 (95% CI: 0.16-0.59) for females and males for rectal cancer. There was no change in colon cancer risk associated with folate intake. There was an indication of an interaction of folate and alcohol intake; the difference in risk associated with low and high folate intake was highest for males in the highest alcohol category. Associations were of similar magnitude for other dietary factors correlated with folate. It appears that intake of folate or a correlated factor may be negatively related to risk of rectal cancer.

Alcohol Drinking↗
PubMed1991

Lag time between stress events and risk of recurrent episodes of inflammatory bowel disease.

We followed a cohort of 124 subjects with a history of inflammatory bowel disease to ascertain risk estimates for clinically active disease associated with exposure to recent stress events. We calculated risk estimates for three lag models (-1, 0, + 1 month). The data indicated a strong association between stress exposures and new clinical episodes of disease (RR = 2.9, 95% Cl: 2.0-4.1), most apparent in the immediate period (lag = 0). Risk estimates were also elevated for extended episodes of disease in subjects under stress compared with unexposed subjects. These results underscore the importance of monitoring stress exposures in prevention and treatment of recurrent disease.

Acute Disease↗
PubMed1990

Risks associated with source of fiber and fiber components in cancer of the colon and rectum.

In this case-control study, we examined the food sources of fiber and fiber solubility to determine whether particular components of dietary fiber were differentially associated with risk of colon and rectal cancer. In Western New York, cases with pathologically confirmed, single, primary cancers of the colon and rectum as well as age-, sex- and neighborhood-matched controls were interviewed from 1975-1986. The sample included 428 colon case-control pairs (223 females, 205 males) and 422 rectal case-control pairs (145 females, 277 males). Subjects were interviewed regarding usual quantity and frequency of consumption of foods. For the colon, risk decreased with intake of grain fiber for both females and males and with intake of fruit/vegetable fiber for males only. Insoluble grain fiber was more strongly associated with risk than soluble grain fiber. For the rectum, fruit/vegetable fiber was associated with decreased risk, whereas grain fiber was not. There was no difference in risk for soluble and insoluble fiber components for the rectum. Analysis of risk associated with fiber by food source and by components of the fiber may provide insight into possible mechanisms of a fiber effect on cancer of the colon and rectum.

Colonic Neoplasms↗
PubMed1990

Lifetime alcohol intake and risk of rectal cancer in western New York.

The lifetime intake of total alcohol, beer, wine, and hard liquor was measured for 277 males and 145 females with pathologically confirmed, first, single, primary cancers of the rectum in western New York from 1978 to 1986. Controls who were age, sex, and neighborhood matched were also interviewed. Intake of beer and total alcohol was positively associated with rectal cancer risk. Most of the excess risk was found for the heaviest drinkers. Odds ratios for fourth quartile intakes for males were 1.80 (95% CI, 1.12, 2.89) for total alcohol and 1.86 (1.13, 3.06) for beer. No association was found with wine or hard liquor intake. Females drank considerably less in this population; trends were similar although not of as great magnitude as those for males. Adjustment for dietary risk factors did not change risk estimates appreciably. A high lifetime intake of beer and total alcohol was associated with an increased risk of rectal cancer, and this was independent of either socioeconomic status or diet.

Adolescent↗
PubMed1990

Patterns in food use and their associations with nutrient intakes.

This study used the frequency of food-use data collected previously in the Western New York Diet Study, a case-control study of diet and cancer at various sites, to develop measures of dietary patterns for subsequent use in epidemiologic research. Factor analysis was applied to frequency-of-use data of 110 foods for 1475 male and 780 female control subjects. Nine dietary-pattern factors were extracted for each gender. Correlational analyses examined relationships with intakes of nutrients of concern to cancer epidemiologists--energy, total fat, dietary fiber, and vitamins A and C. Findings indicate that the usual measure for assessing dietary risks, quantile of nutrient intake, reflects several dietary patterns differing in their composition of cancer risk factors. Furthermore, patterns may relate to such variables as age, ethnicity, and income, which are themselves related to cancer. This approach may provide a comprehensive measure of dietary exposure for epidemiologic research.

Diet↗
PubMed1990

A case-control study of diet and rectal cancer in western New York.

In three counties in western New York, a case-control study of incident, pathologically confirmed, single, primary cancers of the rectum was conducted from 1978 to 1986. Cases were matched with neighborhood controls on age and sex; 277 case-control pairs of males and 145 case-control pairs of females were interviewed regarding usual quantity and frequency of consumption of foods. Risk of rectal cancer increased with increasing intake of kilocalories, fat, carbohydrate, and iron. Risk decreased with increasing intake of carotenoids, vitamin C, and dietary fiber from vegetables. Fiber from grains, calcium, retinol, and vitamin E were not associated with risk. Associations of intake with risk were generally stronger for males than for females except for vitamin C. The association for carotenoids, vitamin C, and vegetable fiber persisted after stratification on intake of either kilocalories or fat.

Aged↗