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Biomedical subjects

L Lipworth

Publications and source records attributed to L Lipworth.

At least 55 records · Page 3Linked to original sources
PubMed1996

Dietary factors and the risk of endometrial cancer: a case--control study in Greece.

In a hospital-based case-control study of endometrial cancer undertaken in Athens (1992-94), 145 women residents of Greater Athens with confirmed cancer of the endometrium were compared with 298 control patients with orthopaedic diseases. Personal interviews were conducted in the hospital setting, and diet was assessed using a validated semiquantitative food frequency questionnaire. Nutrient intakes for individuals were calculated by multiplying the nutrient intake of a typical portion size for each specified food item by the frequency at which the food was consumed per month and summing these estimates for all food items. Data were modelled through logistic regression, controlling for demographic, reproductive and somatometric risk factors for endometrial cancer as well as for total energy intake. No macronutrient was significantly associated with endometrial cancer risk, but increasing intake of monounsaturated fat, mostly olive oil, by about one standard deviation was associated with a 26% risk reduction (odds ratio = 0.74; 95% confidence interval 0.54-1.3). Among micronutrients, only calcium intake was significantly inversely associated with endometrial cancer risk, whereas there was evidence against retinol and zinc imparting protection against the disease. With respect to food groups, there was weak and non-significant evidence that vegetables are protective, whereas consumption of pulses was positively associated with disease possibly because they contribute substantially in Greece to energy intake in excess of physical activity-dependent requirements.

Case-Control Studies↗
PubMed1996

Serum steroid hormone levels, sex hormone-binding globulin, and body mass index in the etiology of postmenopausal breast cancer.

Serum concentrations of estrone, androstenedione, testosterone, and sex hormone-binding globulin (SHBG) were measured postoperatively in 122 postmenopausal women with incident breast cancer and 122 age-matched population controls. After mutual adjustment, through conditional logistic regression, between the hormonal variables and body mass index (BMI), the odds ratios for increasing control-defined quartiles of estrone and androstenedione, respectively, were 1.00, 1.44, 1.76, 1.94 and 1.00, 0.83, 0.97, 2.43; there was no association of testosterone with breast cancer risk. Moreover, the odds ratios for increasing quartiles of SHBG and BMI were 1.00, 0.72, 0.28, 0.25 and 1.00, 0.39, 0.28, 0.19, respectively. This study reveals sharp contrasts in breast cancer risk between women with high estrone and low BMI and SHBG, vs women with low estrone and high BMI and SHBG.

Aged↗
PubMed1996

Epithelial, possibly precancerous, lesions of the lung in relation to smoking, passive smoking, and socio-demographic variables.

We have undertaken an autopsy-based study to evaluate the etiologic importance of active and passive smoking, as well as socio-demographic variables, in the development of pathologic precursors of lung cancer. Lung specimens were taken at autopsy from 531 persons who had died within four hours from a cause other than respiratory or cancer in Athens (Greece) or the surrounding area. Specimens were examined blindly for basal cell hyperplasia, squamous cell metaplasia, cell atypia and mucous cell metaplasia, i.e., pathological entities considered as epithelial, possibly precancerous, lesions (EPPL). Interviews were conducted with next of kin of the deceased. Suitable autopsy specimens as well as completed interviews were eventually available for 275 subjects. EPPL score was regressed on the available independent variables. EPPL score was higher among active smokers than among nonsmokers, while ex-smokers occupied an intermediate position. Conditional on smoking habits, EPPL score was higher among women than among men and higher among manual than among non-manual workers, in agreement with the corresponding patterns with respect to lung cancer. Nonsmoking women married to ever smokers had significantly higher EPPL score than those married to never smokers. The overall findings of this study suggest that EPPL is a valuable indicator of lung cancer risk and that exposure to environmental tobacco smoke is associated with higher EPPL levels and therefore with higher lung cancer risk.

Adult↗
PubMed1996

Breast size and mammographic pattern in relation to breast cancer risk.

The relation of Wolfe's parenchymal patterns and radiographically-assessed breast size with breast cancer risk was evaluated in a population-based nested case-control study in Uppsala, Sweden. All women who attended a mammographic screening programme in Uppsala county starting in 1988 have been followed for the occurrence of breast cancer through 1993. The analysis was based on 295 cases and 589 age-matched controls, whose mammograms were blindly evaluated for parenchymal pattern and breast size. Women with P2 or DY pattern had a significantly elevated risk of breast cancer compared with women with N1 or P1 (OR = 2.09; 95% CI = 1.52-2.86). There was an inverse association of breast size with breast cancer risk, which disappeared after adjusting for parenchymal pattern, because breasts of smaller size tended to have high-risk parenchymal patterns. It is concluded that in Swedish women, and perhaps in Caucasian women in general, small breast size is associated with increasing breast risk through its association with high-risk parenchymal pattern. This is in contrast to the fact that Asian women, who in general have breasts of smaller size, have low prevalence of high-risk parenchymal pattern as well as low rates of breast cancer.

Adult↗
PubMed1995

Diet and overall survival in elderly people.

OBJECTIVE: To assess the influence of a specific dietary pattern on overall survival. DESIGN: Cohort study. SETTING: Three rural Greek villages, the data from which were collected as part of an international cross cultural study of food habits in later life. SUBJECTS: 182 elderly residents of the three villages. MAIN OUTCOME MEASURE: Overall mortality. RESULTS: Diet was assessed with a validated extensive semiquantitative questionnaire on food intake. A one unit increase in diet score, devised a priori on the basis of eight component characteristics of the traditional common diet in the Mediterranean region, was associated with a significant 17% reduction in overall mortality (95% confidence interval 1% to 31%). CONCLUSION: A diet meeting currently understood health criteria does predict survival among people.

Aged↗
PubMed1995

Correlation of estrogen levels between successive pregnancies.

To date, no study has attempted to correlate hormone levels between successive pregnancies in the same woman. Serum levels of total estradiol and total free estradiol have been measured between the eighth and the 17th weeks in the first and second full-term pregnancies of 34 white women participating in the Collaborative Perinatal Study, 1959-1965. Intraindividual interpregnancy Pearson's product moment correlations were calculated. Partial correlation coefficients (adjusted for gestational age) for log pregnancy total estradiol and total free estradiol were 0.78 and 0.73, respectively (p < 0.001). These findings provide evidence that levels of pregnancy estradiol are significantly and strongly correlated in successive pregnancies of the same woman. This phenomenon can provide an explanation for the higher concordance of breast cancer incidence between two sisters than between a mother and daughter in the familial pattern of breast cancer.

Breast Neoplasms↗
PubMed1995

Oral contraceptives, menopausal estrogens, and the risk of breast cancer: a case-control study in Greece.

In a hospital-based case-control study in Athens, we examined the association between the use of oral contraceptives and menopausal estrogens and the risk of breast cancer. Eight hundred and twenty patients with confirmed breast cancer were compared with 795 orthopedic patient controls and 753 healthy visitor controls, matched to the cases by age and interviewer. The data were modeled through logistic regression, controlling for demographic and reproductive variables. Odds ratio patterns were similar for the 2 control series, which were therefore combined to increase precision of the estimates. The risk for breast cancer was not elevated among ever-users of oral contraceptives, regardless of age at diagnosis of breast cancer, duration of oral contraceptive use or timing of use in relation to first full-term pregnancy. Among peri- and post-menopausal women who ever used menopausal estrogens, with never-users as the baseline, a statistically significant elevated odds ratio was found after adjusting for age at menopause.

Breast Neoplasms↗
PubMed1995

Abortion and the risk of breast cancer: a case-control study in Greece.

We have examined the association between induced or spontaneous abortion and breast cancer risk in Greece. In a hospital-based case-control study in Athens, 820 patients with confirmed breast cancer were compared with 795 orthopedic patient controls and 753 healthy visitor controls, matched to cases by age and interviewer. Logistic regression was used to analyze the data, controlling for demographic, reproductive and nutritional variables. Odds ratio (OR) patterns were similar for the 2 control series, which were therefore combined to increase precision of the estimates. The risk for breast cancer was not increased for women who had a history of abortion, compared to nulliparous women with no history of abortion. Thus ORs and 95% confidence intervals were for nulliparous women with spontaneous abortion, 1.17 (0.64-2.13); for nulliparous women with induced abortion, 0.98 (0.56-1.73); for parous women with no abortion, 0.56 (0.31-1.01); for parous women with spontaneous abortion, 0.61 (0.33-1.14) and for parous women with induced abortion, 0.99 (0.56-1.74). When the analysis was restricted to parous women, using parous women with no history of abortion as the baseline, ORs and 95% confidence intervals were for induced abortion before first full-term pregnancy, 2.06 (1.45-2.90); for induced abortion after first full-term pregnancy, 1.59 (1.24-2.04) and for spontaneous abortion, 1.10 (0.82-1.40). Our findings suggest that an interrupted pregnancy does not impart the long-term protective effect of a full-term pregnancy attributable to terminal differentiation.

Abortion, Induced↗
PubMed1995

Olive oil, other dietary fats, and the risk of breast cancer (Italy).

Data from a multicenter case-control study on breast cancer conducted in Italy have been used to analyze the relationship of olive oil and other dietary fats to breast cancer risk. Cases were 2,564 women hospitalized with histologically confirmed, incident breast cancer. Controls were 2,588 women admitted to the same network of hospitals for acute, non-neoplastic, non-hormone related, non-digestive tract disorders. Cases and controls were interviewed between 1991 and 1994 using a validated food-frequency questionnaire. The data were modelled through multiple logistic regression controlling for demographic and reproductive breast-cancer risk factors, energy intake and, mutually, for types of dietary fat. For olive oil, compared with the lowest quintile, the odds ratios (OR) were 1.05, 0.99, 0.93, and 0.87 for increasing quintiles of intake; in a model postulating linear logit increase, the OR per unit (30 g) was 0.89 (95 percent confidence interval [CI] = 0.81-0.99, P = 0.03). Among other oils or fats considered, the OR for the highest level of intake was 0.72 (CI = 0.6-0.9) for a group of specific seed oils (including safflower, maize, peanut, and soya) compared with nonusers. The ORs for the highest cf lowest level of intake were 0.80 for mixed or unspecified seed oils, 0.95 for butter, and 0.96 for margarine. The study, based on a large dataset from various Italian regions, shows an inverse relationship of breast cancer risk with intake of olive oil and other vegetable oils, but not with butter or margarine.

Adult↗
PubMed1995

Organochlorine compounds and estrogen-related cancers in women.

The organochlorines, a diverse group of some 15,000 compounds, have been implicated increasingly as being harmful to humans. Some congeners of DDT and PCB elicit very weak estrogenic responses in animals, while the dioxin TCDD and related compounds have antiestrogenic properties. This review summarizes the evidence regarding whether certain organochlorine compounds, usually as persistent food-chain contaminants, increase the risk of breast and endometrial cancers through their estrogenic potential. In humans, neither ecologic data nor occupational studies provide clear support for an association between organochlorine exposure and the occurrence of these cancers. In our summary analysis of occupational exposure, the rate ratio of breast cancer for exposed cf unexposed women was 0.84 (95 percent confidence interval [CI] = 0.50-1.33) for PCBs and 1.08 (CI = 0.68-1.58) for TCDD. Similarly, effect estimates close to unity were found in summary analysis of breast cancer case-control studies regarding levels of DDE and PCB in adipose tissue or serum. In two recent nested case-control studies using stored specimens, the odds ratio per standard deviation increase in serum p,p'-DDE was 1.27 (CI = 0.95-1.69). Although estrogenic effects of certain organochlorine compounds should be easier to detect on the endometrium, we know of no analytic epidemiologic studies of endometrial cancer published to data. We conclude that available data do not indicate that organochlorines will affect the risk of these two cancers in any but the most unusual situation.

Adipose Tissue↗
PubMed1995

Organochlorine compounds in relation to breast cancer, endometrial cancer, and endometriosis: an assessment of the biological and epidemiological evidence.

There is an increasing public and scientific concern that certain chlorinated compounds, recognized as environmental pollutants, may cause estrogen-related neoplastic disease in humans. The main hypothesis has been that certain organochlorines, through their estrogenic actions, might cause breast cancer. From experimental studies, both in vitro and in vivo, there is evidence that certain organochlorine compounds may cause estrogenic effects, whereas others may cause antiestrogenic effects. In limited studies, some of these compounds in high doses have also been shown to increase and reduce the frequency of estrogen-related tumors in animals. The epidemiological findings regarding the association between organochlorines and breast cancer are inconclusive. However, the largest and best designed study has been interpreted as negative with respect to DDT and polychlorinated biphenyls (PCB) in relation to breast cancer. Associations between organochlorine exposure and endometrial cancer or endometriosis have even more limited empirical basis. The hypothesis that human exposure to environmental levels or organochlorines would favor an estrogenic overactivity leading to an increase in estrogen-dependent formation of mammary or endometrial tumors is not supported by the existing in vitro, animal and epidemiological evidence. It can, however, not be conclusively rejected on the basis of available data.

Animals↗
PubMed1989

Risk of fractures in an intermediate care facility for persons with mental retardation.

The epidemiology of fractures among 553 residents of an intermediate care facility for persons with mental retardation was examined. In a 10-month period, 61 fractures occurred among 55 residents; application of fracture rates in the United States revealed an expected number of 15 fractures among the 553 residents, p less than .001. Although 52% of fractures involved small bones of the hands and feet, elderly residents were more likely to fracture major bones and to suffer their fractures from a fall than were younger residents. The relationship between potential risk factors and fracture risk were examined and implications for preventive and rehabilitative measures discussed.

Accidental Falls↗
PubMed1985

The clinical use of mindfulness meditation for the self-regulation of chronic pain.

Ninety chronic pain patients were trained in mindfulness meditation in a 10-week Stress Reduction and Relaxation Program. Statistically significant reductions were observed in measures of present-moment pain, negative body image, inhibition of activity by pain, symptoms, mood disturbance, and psychological symptomatology, including anxiety and depression. Pain-related drug utilization decreased and activity levels and feelings of self-esteem increased. Improvement appeared to be independent of gender, source of referral, and type of pain. A comparison group of pain patients did not show significant improvement on these measures after traditional treatment protocols. At follow-up, the improvements observed during the meditation training were maintained up to 15 months post-meditation training for all measures except present-moment pain. The majority of subjects reported continued high compliance with the meditation practice as part of their daily lives. The relationship of mindfulness meditation to other psychological methods for chronic pain control is discussed.

Adaptation, Psychological↗
PubMed1985

Pharyngeal carriage rates of Haemophilus influenzae, type b and non-b, and prevalence of ampicillin-resistant Haemophilus influenzae among healthy day-care children in central Massachusetts.

Pharyngeal swabs were obtained from 832 children less than 14 years of age attending day-care centers and family day-care homes in central Massachusetts during a seven-week period beginning March 1, 1982. Colonization rates for Haemophilus influenzae and for H. influenzae type b were 60.7% and 15.1%, respectively. Nonwhite children were more likely to be carriers of non-b H. influenzae than white children (62.9% vs. 47.8%, p less than 0.025). Children in day care for more than six months were more likely to be carriers of non-b H. influenzae than children in day care for six months or less (52.9% vs. 45.5%, p less than 0.05). There was no association between colonization rates and age, sex, type of day-care setting, number of siblings, number sharing a bedroom, history of otitis media, or history of antibiotic use. The prevalence of ampicillin-resistant H. influenzae was 6.3% among all children and 10.3% among carriers of H. influenzae. The prevalence of ampicillin resistance was significantly higher among type b carriers than among carriers of other types (15.1% vs. 8.3%, p less than 0.05). Children who had taken ampicillin or amoxicillin within the past three months were much more likely to be colonized with ampicillin-resistant H. influenzae than were children who had not taken these antibiotics (13.5% vs. 4.8%, p less than 0.0005). These observations have important clinical implications for the management of children with H. influenzae disease.

Adolescent↗