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Biomedical subjects

K Katsouyanni

Publications and source records attributed to K Katsouyanni.

At least 91 records · Page 5Linked to original sources

Dietary factors and risk of breast cancer: combined analysis of 12 case-control studies.

We conducted a combined analysis of the original data to evaluate the consistency of 12 case-control studies of diet and breast cancer. Our analysis shows a consistent, statistically significant, positive association between breast cancer risk and saturated fat intake in postmenopausal women (relative risk for highest vs. lowest quintile, 1.46; P less than .0001). A consistent protective effect for a number of markers of fruit and vegetable intake was demonstrated; vitamin C intake had the most consistent and statistically significant inverse association with breast cancer risk (relative risk for highest vs. lowest quintile, 0.69; P less than .0001). If these dietary associations represent causality, the attributable risk (i.e., the percentage of breast cancers that might be prevented by dietary modification) in the North American population is estimated to be 24% for postmenopausal women and 16% for premenopausal women.

Body Height↗

Maternal age, parity, and pregnancy estrogens.

Total estrogens (TE), estradiol (E2), estriol (E3), and human placental lactogen (hPL) were determined by radioimmunoassay in the blood of 126 pregnant women during their 26th and 31st weeks of pregnancy and the results were studied in relation to maternal age and parity. Total estrogens and E2 were lowest among the youngest women (less than 20 years) and highest among women aged 20-24 years, whereas older women (25+ years) had, on the average, intermediate values. For E3 the pattern was qualitatively similar to that of TE and E2 but less striking, and no maternal age pattern was evident with respect to hPL. Within maternal age groups, TE and E2 were higher among women in the first, than among those in their second, full-term pregnancy; the difference was about seven percent for TE (P = 0.14) and about 14 percent for E2 (P = 0.05). No parity patterns were evident with respect to E3 and hPL. There were fairly strong correlations between the determinations of the same hormone in the same woman during the 26th and 31st weeks of pregnancy; Pearson correlation coefficients were 0.60 for TE, 0.78 for E2, 0.60 for E3, and 0.72 for hPL. Since the risk of breast cancer increases apparently monotonically with maternal age at birth, the present data are equivocal with respect to the hypothesis linking levels of pregnancy estrogens to risk of breast cancer in the offspring. However, the data are compatible with hypotheses linking excessive pregnancy-estrogen exposure to conditions more common among first-born individuals, including testicular cancer and cryptorchidism.

Adult↗

Passive smoking and diet in the etiology of lung cancer among non-smokers.

A case-control study was undertaken in Athens to explore the role of passive smoking and diet in the causation of lung cancer, by histologic type, in non-smoking women. Among 160 women with lung cancer admitted to one of seven major hospitals in Greater Athens between 1987 and 1989, 154 were interviewed in person; of those interviewed, 91 were life-long non-smokers. Among 160 identified controls with fractures or other orthopedic conditions, 145 were interviewed in person; of those interviewed, 120 were life-long non-smokers. Marriage of a non-smoking woman to a smoker was associated with a relative risk for lung cancer of 2.1 (95% confidence interval [CI] 1.1-4.1); number of cigarettes smoked daily by the husband and years of exposure to husband's smoking were positively, but not significantly, related to lung cancer risk. There was no evidence of any association with exposure to smoking of other household members, and the association with exposure to passive smoking at work was small and not statistically significant. Dietary data collected through a semi-quantitative food-frequency questionnaire indicated that high consumption of fruits was inversely related to the risk of lung cancer (the relative risk between extreme quartiles was 0.27 (CI 0.10-0.74)). Neither vegetables nor any other food group had an additional protective effect; furthermore, the apparent protective effect of vegetables was not due to carotenoid vitamin A content and was only partly explained in terms of vitamin C. The associations of lung cancer risk with passive smoking and reduced fruit intake were independent and did not confound each other.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

Tobacco smoking, pregnancy estrogens, and birth weight.

It has been suggested that tobacco smoking during pregnancy reduces birth weight by lowering production rates or levels of total pregnancy estrogens. To evaluate this hypothesis, we examined total estrogen levels by radioimmunoassay in the blood of 141 pregnant women attending the maternity clinic of a major university hospital in Athens during their 26th week of pregnancy. Forty-nine of these women were regular smokers before and during their pregnancy, whereas the remaining 92 had never been regular smokers and did not smoke at all during their pregnancy. Birth weight of offspring was lower among smokers than among nonsmokers by 190.8 g, with a 90% confidence interval of 41.1 to 340.5 g, and higher among women with higher serum estrogen levels (slope b = 1.2 g per 1000 pg/ml with a 90% CI of 0.2 to 2.2 g). There was, however, only a small negative relation between tobacco smoking and serum estrogen levels; in smokers, total estrogen levels were reduced to 91% of the corresponding levels among nonsmokers.

Adult↗

Air pollution and cause specific mortality in Athens.

STUDY OBJECTIVE: The aim was to investigate the reported association between air pollution and cause specific mortality in the city of Athens. DESIGN: Cause specific mortality was contrasted between 199 d with high values of air pollution and 2*199 comparison days with low pollution, matched in a 1:2 ratio on the basis of various confounding factors. Statistical analysis was done, taking matching into account, using analysis of variance for randomised blocks. SETTING: The study was confined to the city of Athens, using data obtained between 1975 and 1982. PARTICIPANTS: Cause of death was assessed in all 25 138 persons dying in the 3*199 d studied. MEASUREMENTS AND MAIN RESULTS: Causes of death were evaluated blindly by two medically qualified investigators on the basis of information in the death certificates. Mortality was generally higher during the high pollution days but the difference was more pronounced and more significant for respiratory conditions, even though the number of deaths in this category was smaller than the corresponding numbers in the other two categories examined (cardiac and "other" deaths). CONCLUSION: The results show that the short term association between air pollution and overall mortality in Athens is likely to be causal, since it is particularly evident with respect to respiratory conditions, for which a biological air pollution link is more plausible.

Air Pollution↗

An evaluation of the effectiveness of tobacco-control legislative policies in European Community countries.

The purpose of this paper was to assess the effectiveness of anti-tobacco smoking legislation from 1948 onwards in reducing actual per capita tobacco consumption in the twelve countries of the European Economic Community (EEC). In order to undertake these assessments a score was assigned to every legislative measure, indicating the a priori likely impact of this measure on tobacco consumption. Two approaches were then utilized. In the first, it was found that the cumulative anti-tobacco legislative score correlates well in time with a reduction of tobacco consumption. In the second, cross-sectional data from the EEC countries and multiple regression modelling were used to estimate the elasticities of tobacco price, per capita income and cumulative anti-tobacco legislation score; it was found that legislation has an impact on tobacco consumption which, although considerably smaller than the corresponding impact of tobacco price levels, is nominally significant and potentially important. The evaluative approaches utilized in this paper are based on observational data of ecologic nature and can provide only weak evidence about the causal nature of the reported associations. Nevertheless, this limited evidence suggests that legislative measures may be effective both by affecting price levels and through other mechanisms, including health education and the formation of a more general anti-smoking ethos.

Europe↗

Clinical, laboratory and immunologic effects of the treatment of endemic goiter with T4, T3 and KI.

We treated 204 patients with endemic nontoxic goiter with T4, T3 and KI, singly or in combination. Definitely nodular goiters were excluded, since the possibility of autonomy would be increased. Goiter size was evaluated before and 6 months after treatment clinically in a blind way, i.e. the observer (always the same) did not know either the pretreatment goiter size or the treatment the patient had received. At the same time various laboratory parameters were recorded. All the active treatments (but not placebo) resulted in a highly significant decrease in the gland size. The effectiveness decreased in the following order: 1) T3 50 micrograms/d (most effective), 2) (T4 50 micrograms/d + T3 12.5 micrograms) x 2, 3) T4 150 micrograms + iodide 150 micrograms/d, 4) T4 75 micrograms + T3 18.75 micrograms/d, 5) T4 200 micrograms/d, 6) T3 37.5 micrograms/d, 7) Iodide 300 micrograms/d, 8) T4 150 micrograms/d, 9) Iodide 150 micrograms/d (least effective) and 10) Placebo (not effective). The results show that T4 200 micrograms and T3 50 micrograms are roughly equipotent, and slightly more effective than 300 micrograms of Iodide. Taking into consideration the side effects (increase in pulse rate, shortening of the Achilles tendon reflex) did not change the order of effectiveness in an important way. The clinical outcome correlated in general with the suppression of the 131I uptake (r = 0.220, p = 0.03) and the TRH test (r = 0.248, p = 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Autoantibodies↗

Diet and cancer: methodological complexities and case-control studies in Greece.

Some methodological difficulties of epidemiological studies exploring the role of diet in the etiology of human cancer are considered and suggested corrective approaches are discussed. The advantages and disadvantages of case-control studies in this field are critically examined. The results and implications of several such studies undertaken in Greece are reviewed.

Bias↗

A case-control study of the relationship between smoking, diet, and gallbladder disease.

Eighty-four women with roentgenographically confirmed gallbladder disease and 171 control women hospitalized at a trauma hospital in Athens, Greece, were interviewed regarding demographic, reproductive, smoking, and dietary characteristics. A food-frequency approach was used to elicit consumption of 120 food or beverage items during the period before the onset of the current illness or hospitalization. The patients were substantially less likely to be regular cigarette smokers before the current admission. Additionally the patients reported significantly less frequent consumption of total items contained in the following food groups: sugars; pulses, nuts, beans; fish; and dairy products. On average they also consumed significantly fewer alcoholic beverages. On the other hand, the patients reported more frequent consumption of items in the following food groups: cereals, potatoes, fruits, meats, fats and oils, and coffee/tea. After controlling for confounding between food groups through multiple logistic regression models, the patients were still found to be less frequent consumers of vegetables and alcoholic beverages but more frequent consumers of potatoes and items in the cereal group. These analyses also confirmed the reduced likelihood of the patients being smokers.

Adult↗

Exposure to lead and cadmium of children living near a lead smelter at Lavrion, Greece.

Exposure of children of the Greek town of Lavrion to lead and cadmium has been evaluated by determination of the levels of lead (PbB) and cadmium (CdB) in the blood of 514 children living in the town. The Lavrion area is heavily polluted by lead owing to the presence of a large lead-zinc mining and smelting industrial complex. The industrial PbB level (geometric mean) was 21.7 micrograms dl-1 (range 7.4-79.8 micrograms dl-1). The CdB levels were, on average, 0.36 micrograms l-1 (range 0.1-3.1 micrograms l-1). The results were evaluated with respect to a number of constitutional, social and environmental variables, such as age, gender, distance of the school from the lead-zinc mining and smelting complex, and occupation and education of the father.

Age Factors↗

Risk factors of peripheral arterial occlusive disease: a case-control study in Greece.

A case-control study concerning peripheral arterial occlusive disease (PAOD) was conducted in Athens, Greece. The case series consisted of 100 patients with PAOD as principle diagnosis admitted consecutively to a major teaching hospital in Athens during an 18-month period. The controls were patients hospitalized in the same hospital during the same period as the index cases for conditions requiring minor surgical care. All cases and controls were interviewed by the same person about several socioeconomic, demographic and medical variables; blood pressure and blood glucose values were also recorded. Data were analysed using multiple logistic regression procedures, controlling for age, sex and years of schooling. Tobacco smoking, systolic blood pressure, diabetes mellitus, heavy alcohol drinking and excessive coffee consumption were all strong independent risk factors with eight-fold or more differences in risk. It appears that PAOD as an atherosclerotic disease with low short-term fatality reveals in more contrasting terms the aetiological importance of factors involved in the atherosclerotic process as compared to atherosclerotic conditions with higher short-term fatality like coronary heart disease (CHD) which may also have stronger thrombotic components.

Adult↗

Study of the patients' difficulties in ending brief psychoanalytic psychotherapy.

Brief psychotherapy implies a limitation of the time needed, which should meet both the patient's acceptance and the therapist's awareness. However, some patients have difficulties in ending therapy. The material of this study consists of 27 patients. Of these patients, 5 dropped out in the termination phase, while for another 8 it became apparent a little before or after the final phase that psychotherapy would have to be continued. The results of the statistical analysis--factor analysis and analysis of variance for the investigation of therapists' difficulties, and discriminant analysis to assess differences concerning the suitability of patients for brief psychotherapy--showed that: (1) the less a therapist feels self-confident, the more likely his/her patient is to break off therapy at the termination point, and (2) the suitability score, determined during evaluation, emerges as the main differentiating parameter of the three groups (dropouts, continuers, completers).

Countertransference↗

Risk of breast cancer among Greek women in relation to nutrient intake.

A case-control study of the role of diet in the cause of breast cancer was conducted in Athens, Greece. The case series consisted of 120 consecutive patients with histologically confirmed breast cancer admitted to either of two teaching hospitals over a 12-month period. The controls were 120 patients admitted to a teaching hospital for trauma and orthopedic conditions during the same period. Dietary histories concerning the frequency of consumption of 120 foods and drinks were obtained by interview. Nutrient intakes for individuals were estimated by multiplying the nutrient content of a selected typical portion size for each specified food item by the frequency that the food was used per month and summing these estimates for all food items. Cases reported significantly less frequent consumption of vitamin A after controlling for total caloric intake, potential external confounding variables and other nutrients associated with breast cancer risk. The odds ratio estimated for consumption of vitamin A equal to the value of the 90th centile versus consumption equal to the value of the 10th centile was 0.46 with 90% confidence limits 0.26-0.82. There was no evidence that high intake of dietary fat increases the risk of breast cancer.

Breast Neoplasms↗

Cerebrospinal fluid carcinoembryonic antigen and alphafetoprotein in patients with central nervous system neoplasia.

A solid phase immunoassay was used to evaluate the levels of serum and cerebrospinal fluid of alphafetoprotein and carcinoembryonic antigen in 33 individuals treated for backache and headache with no evidence of organic neurological disease, 19 patients with primary CNS tumor (benign or malignant) and 22 with CNS metastasis from a solid tumor. AFP serum and CSF levels were found in trace amounts or slightly elevated not exceeding normal limits in all groups. Patients with CNS metastasis were found to have statistically significant higher CEA levels (both in serum and CSF) than the control group, and the patients with primary brain tumors. Patients with leptomeningeal dissemination had statistically significantly higher CEA CSF levels than did patients with primary tumors, and patients with parenchymal metastasis.

Adult↗

Time trends of tobacco smoking, air pollution, and lung cancer in Athens.

Athens is a city with a serious air pollution problem which has existed for more than 20 years. To evaluate whether air pollution has affected lung cancer incidence (and hence, mortality) in the population of Athens we have compared standardized lung mortality between Athens and the rest of Greece taking into account the tobacco consumption trends in the respective populations and varying the postulated latency between 0 and 20 years. There is no evidence for an independent or interactive (with tobacco smoking) effect of air pollution on lung cancer mortality; the tobacco-adjusted mortality appears, if anything, lower in Athens than in the rest of Greece and the slopes of lung cancer mortality on tobacco consumption are almost identical in Athens and in the rest of Greece. By contrast, the same data are compatible with a strong effect of tobacco smoking on lung cancer mortality, an effect which appears to involve not only the early carcinogenic stages but also some of the later ones. The results of the present analysis do not support the hypothesis that air pollution, at least in Athens until 1980, has increased the incidence of lung cancer to an extent large enough to be detectable in ecological correlation analyses. Nevertheless the inherent limitations of these methods indicate that their results should be interpreted with caution and only as a step toward the gradual understanding of a complex issue.

Air Pollution↗

Social and resource factors related to the utilization of emergency psychiatric services in the Athens area.

Emergency Psychiatric Service of the Department of Psychiatry at the University of Athens is the only referral service for the emergency psychiatric cases coming from the Athens greater area. During 1981 2,169 patients used the Service. The relations of socio-demographic and resource factors of the 26 districts of the greater area of Athens to a Standardized Psychiatric Emergencies Index (S.P.E.I.) are investigated in the study. Unemployment, education, profession, distance from the service, psychiatric coverage and involuntary incoming were considered as independent variables and S.P.E.I. for 1981 as a dependent variable. Multiple regression analysis showed that the only factor significantly correlated with the emergency use of the psychiatric service is the distance from the Facility.

Cross-Sectional Studies↗