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Biomedical subjects

K L Noller

Publications and source records attributed to K L Noller.

At least 37 records · Page 2Linked to original sources
PubMed1988

Cancer after exposure to metronidazole.

We assessed the risk of occurrence of cancer associated with exposure to metronidazole in the 771 female residents of Rochester, Minnesota, who were treated with metronidazole for vaginal trichomoniasis during the period 1960 through 1969 and were followed up for a total of 12,628 person-years. Standardized morbidity and mortality ratios were determined by using an expected number calculated by applying age-specific incidence rates from Rochester studies and Cancer Surveillance, Epidemiology, and End-Results Reporting (SEER) data to the person-years of follow-up. The overall standardized morbidity ratios for cancer at all sites were 1.4 (Rochester, 1978 through 1983), 1.5 (SEER data for Iowa, 1978 through 1981), and 1.2 (SEER data for Connecticut, 1978 through 1981). By site of the cancers, the standardized morbidity ratios greater than unity were those for malignant lesions of the lung, breast, thyroid, bladder, brain, kidney, nasopharynx, and oral cavity, as well as for multiple myeloma and malignant melanoma; however, the only significantly elevated standardized morbidity ratio was that for bronchogenic carcinoma. After adjustment for smoking status, the standardized morbidity ratio for bronchogenic cancer was 2.5 (95% confidence interval of 1.3 to 4.4). The standardized mortality ratio for cancer at all sites was 1.4 (95% confidence interval of 0.9 to 2.2). The analysis of these data suggests no significant increase in cancer-related morbidity or mortality for women exposed to metronidazole for treatment of vaginal trichomoniasis.

Carcinoma, Bronchogenic↗
PubMed1988

Comparison of Dacron-tipped applicator and cytobrush for detection of chlamydial infections.

Endocervical samples were obtained from 435 females for Chlamydia detection by using both a Dacron swab and a cytobrush. Positive results were obtained from 35 swabs and 34 cytobrush specimens. All specimens positive with the cytobrush were detected also with swab samples. The cytobrush and Dacron swab appear to be comparable for the detection of endocervical infections with Chlamydia trachomatis.

Chlamydia Infections↗
PubMed1988

Cervical cytology and the evaluation of the abnormal Papanicolaou smear.

The pap smear is a safe, easy, and inexpensive method for the screening of large numbers of sexually active women for the presence of neoplasia of the cervix. When the pap smear is reported as being abnormal, it is highly accurate. Unfortunately, some cytology laboratories report lesions as "Class II" or "atypical." These reports are not helpful to the clinician and require further evaluation. Most sexually active women are at "high risk" for the development of cervical neoplasia because of early sexual activity for multiple sexual partners. All women at high risk should have annual pap smears. If a woman has a pap smear that suggests the presence of CIN (dysplasia or carcinoma in situ), colposcopy should be performed. This office procedure allows for the detection of the areas causing the abnormal cytology. Colposcopy can often allow outpatient therapy of CIN lesions. Conization should be performed only when the colposcopic examination is unsatisfactory or patient or lesion factors are not favorable for office therapy. Hysterectomy is not recommended for treatment of cervical dysplasia or carcinoma in situ.

Colposcopy↗
PubMed1987

Incidence of pelvic endometriosis in Rochester, Minnesota, 1970-1979.

To the authors' knowledge, the incidence pelvic endometriosis in the general female population has not been previously reported. The purpose of the present study was to determine the incidence rate of diagnosed pelvic endometriosis among white females of reproductive age (15-49 years) in Rochester, Minnesota, during 1970-1979. Incidence rates were prepared first with histologically confirmed cases alone and then with the successive inclusion of progressively less certain cases: surgically visualized, clinically probable, and clinically possible. The overall incidence of pelvic endometriosis more than doubled (from 108.8 to 246.9 cases per 100,000 person-years) as the definition of a case was extended from histologically confirmed cases alone to all cases. Age-specific incidence rates increased in successive age groups through age 44 and then declined for women 45-49 years of age. Methodological problems in the definition and ascertainment of incident cases of pelvic endometriosis are described in detail.

Adolescent↗
PubMed1987

Coital risk factors for cervical cancer. Sexual activity among white middle class women.

This study reports the sexual history of a group of young women participating in an epidemiologic project. The methods used to recruit and interview the participants minimized self-selection bias. Results of over 11,000 interviews with 1,892 participants showed that 72.3% should be considered at high risk for developing cervical cancer and its precursors and should be screened regularly for this disease.

Adolescent↗
PubMed1986

Risk factors for the development of diethylstilbestrol-associated clear cell adenocarcinoma: a case-control study.

Factors related to the risk of developing clear cell adenocarcinoma in diethylstilbestrol-exposed women were investigated in 156 patients in the United States with clear cell adenocarcinoma and documented diethylstilbestrol exposure (Registry cases) and 1848 diethylstilbestrol-exposed women of similar age without cancer (National Cooperative Diethylstilbestrol Adenosis Project). Diethylstilbestrol dosage patterns, the use of other hormones, mother's age and pregnancy history, and daughter's birth month, birth weight, and age at menarche were compared. The relative risk was higher for those whose mothers began diethylstilbestrol before the twelfth week of pregnancy and for those who were born in the fall (winter conception). Maternal history of at least one prior spontaneous abortion elevated the risk. Supportive evidence for the difference in birth month distribution was also found by a comparison with United States vital statistics. Each factor was confirmed to be significant in a multivariate logistic model that examined all of them with region and year of birth adjusted.

Adenocarcinoma↗
PubMed1986

Detection of Chlamydia trachomatis using consecutive endocervical swabs. Prevalence in asymptomatic female adolescents and women attending a sexually transmitted disease clinic.

Chlamydia trachomatis is an organism commonly transmitted through sexual intercourse. In women it is associated with cervicitis, salpingitis, perihepatitis and infertility. Neonates born to infected women may have inclusion conjunctivitis and pneumonia due to this organism. Screening in obstetrics and in gynecology clinics is not usually performed routinely because of the cost and time involved in culturing the organism. A rapid enzyme immunoassay (EIA) kit (Chlamydiazyme, Abbott Laboratories) that can detect C. trachomatis was developed recently. Women belonging to two different cohorts were studied to determine whether multiple endocervical samples increased the likelihood of a positive result from this EIA kit. One cohort consisted of 70 asymptomatic, sexually active female adolescents from a local family planning clinic. The second cohort included 80 women who were seen at a sexually transmitted disease (STD) clinic. Both groups were assayed for Chlamydia infections using the rapid EIA kit. Positive test results were found in 7 of the 70 asymptomatic teenagers (10%) and 12 of the 80 women from the STD clinic (15%). No significant differences were noted in the order of the positive swabs in either group, although more of the earlier swabs tended to be positive.

Adolescent↗
PubMed1985

Pathology of colposcopic findings in 2635 diethylstilbestrol-exposed young women.

An analysis of 6055 colposcopically directed biopsy specimens from 2635 diethylstilbestrol (DES)-exposed women and 445 biopsy specimens from 277 nonexposed women was undertaken to correlate microscopic findings with colposcopic patterns. All examinations were performed using a standardized protocol which required that each participant have colposcopy, cytologic smears, and biopsy of abnormal colposcopic lesions. The findings of colposcopic "columnar epithelium, gland openings, and Nabothian cysts" correlated most often with glandular epithelium in the biopsy specimen. "White epithelium," which includes three related colposcopic patterns, mosaicism, punctation, and white epithelium, was associated most frequently (82-93% of cases) with squamous metaplasia, but occasionally with dysplasia and carcinoma in situ (CIS)(0-6%). The presence of dysplasia or CIS in any individual biopsy specimen occurred most frequently with the observation of higher graded lesions by colposcopy or a prior diagnosis of dysplasia.

Carcinoma in Situ↗
PubMed1985

Congenital malformations among offspring exposed in utero to progestins, Olmsted County, Minnesota, 1936-1974.

Comparison of a cohort of 988 offspring exposed in utero to exogenous progestins with a matched cohort of unexposed offspring did not result in detection of an association of congenital anomalies with exposure. The conclusions are based primarily on outcomes of pregnancy with exposure to progesterone and 17 alpha-hydroxyprogesterone caproate, and may not apply to androgenic progestins. Offspring exposed to combinations of progestins and estrogens were excluded from this study and may have a different distribution of anomalies.

17 alpha-Hydroxyprogesterone Caproate↗
PubMed1985

A comparison of pregnancy history recall and medical records. Implications for retrospective studies.

Using data from the Diethylstilbestrol-Adenosis (DESAD) Project, a study of the effects of diethylstilbestrol (DES) exposure during fetal life, the authors compared prenatal records with obstetric history from mother's questionnaires completed 10 or more years after the birth of their daughters. Except for the history of hospitalization and trunk x-ray, no differences were observed in agreement (questionnaire compared with record) between the group of DES-exposed mothers identified through review of their prenatal records and the comparison group of mothers who were not exposed. The authors also compared data from mothers of DES-exposed daughters who initiated their own enrollment in the study (walk-ins and referrals). To obtain prenatal records for these women, physicians were contacted. They would usually supply drug exposure data but not the other obstetric history requested. Mothers of these walk-ins and referrals had slightly better agreement between questionnaire and records when compared with the two groups identified by review of prenatal records. In general, there was good to excellent agreement for all groups when mothers' recall of personal history (past miscarriage, past pregnancy, etc.) was compared with their medical records. However, for medical intervention such as drugs and x-rays, agreement was poor. Of the DES-exposed mothers identified through review of their prenatal records, 29% could not remember whether they took DES. An additional 8% said they did not take DES when it was recorded in their charts.

Clinical Trials as Topic↗
PubMed1984

Increased incidence of cervical and vaginal dysplasia in 3,980 diethylstilbestrol-exposed young women. Experience of the National Collaborative Diethylstilbestrol Adenosis Project.

The incidence rates of dysplasia and carcinoma in situ (CIS) of the cervix and vagina were determined in 3,980 young women exposed prenatally to diethylstilbestrol. Strict criteria were developed to minimize selection bias among the subset of 744 pairs of matched exposed and unexposed (control) cohort participants, all of whom were identified through review of prenatal obstetrical records. A high degree of compliance was achieved throughout the seven-year study period since in each group about 90% of the women remained as active participants, kept 77% of the annual anniversary examinations, and had separate Papanicolaou smears of the cervix and vagina performed in 99% of the anniversary examinations. The incidence rate for dysplasia and CIS was significantly higher in the women exposed to diethylstilbestrol than in those not exposed in the matched cohort (15.7 v 7.9 cases per 1,000 person-years of follow-up). The rates were higher in the exposed women if squamous metaplasia extended to the outer half of the cervix or onto the vagina. In other respects, the matched cohorts were strikingly similar.

Adult↗
PubMed1984

Males exposed in utero to diethylstilbestrol.

An increased frequency of various genitourinary anomalies, infertility, and testicular cancer among males has been reported to follow intrauterine exposure to diethylstilbestrol, but not all studies have confirmed an association. This study was designed to determine whether a cohort of males exposed in utero to diethylstilbestrol had a higher frequency of urogenital abnormalities than an unexposed cohort. Biases in selection of exposed and control participants were minimized. Of 828 exposed and 676 control men studied by medical-record review, 265 exposed men and 274 controls also underwent a special clinical examination. Overall, the data suggest that diethylstilbestrol exposure of males in utero did not increase their risk of genitourinary abnormalities, infertility, or testicular cancer. Previously reported increased frequencies of these abnormalities in diethylstilbestrol-exposed men may have resulted from selection biases or differences in diethylstilbestrol use, or both.

Abnormalities, Drug-Induced↗