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Biomedical subjects

M Macaluso

Publications and source records attributed to M Macaluso.

71 records · Page 4Linked to original sources
PubMed1992

Oral contraceptive use and the incidence of cervical intraepithelial neoplasia.

OBJECTIVE: Our objective was to examine the relationship between oral contraceptive use and the incidence of cervical intraepithelial neoplasia. STUDY DESIGN: In a prospective follow-up study of 6622 women participating in the Second Tromsö Study conducted in 1979 and 1980 in Tromsö, Norway, women aged 20 to 49 years answered a questionnaire regarding their smoking history, dietary habits, alcohol consumption, and oral contraceptive use. They were then followed for 10 years with data from the Pathology Registry of the University Hospital. RESULTS: The age-adjusted incidence rate of cervical intraepithelial neoplasia was 897 per 100,000 person years among noncurrent and 1295 per 100,000 person years among current oral contraceptive users as of 1979. After adjusting for age, marital status, smoking, and frequency of alcohol intoxication the relative rate for current users was 1.5 (95% confidence interval 1.1 to 2.1), and the relative rate for past users was 1.4 (95% confidence interval 1.0 to 1.8), as compared with those who had never used oral contraceptives before 1979. CONCLUSION: These findings support the hypothesis that the occurrence of cervical intraepithelial neoplasia is increased by oral contraceptive use.

Adult↗
PubMed1992

Exact stratification of person-years.

This paper describes methods for the exact assignment of person-years of follow-up to strata of time-dependent factors. It reviews methods applicable to variables that directly measure the passing of time and that increase in step with follow-up (monotonic time factors), and it extends their use to nonmonotonic time factors. When the same categorization scheme is used for all time factors (for example, 5-year categories), the follow-up period consists of segments whose length and position in time are predictable. A new exact method presented here uses this property to improve the efficiency of computations. The new method is generally faster than a method previously described. Finally, the paper outlines a method of exact person-year stratification that is applicable to all time-dependent factors.

Computer Simulation↗
PubMed1991

Validity of a mortality study based on a corporate health surveillance system.

We evaluated the Shell Health Surveillance System (HSS) by conducting two mortality studies at an oil refinery. Study A used the HSS to measure the mortality of active and retired workers during 1973 to 1982. Study B used additional information sources and followed up terminated employees. For subjects included in both studies, results were very similar. However, the mortality experience of terminees before 1973 (included only in study B) was different from that of study A subjects, reflecting differences in length of employment and time since hire. HSS-based studies provide valid measures of long-term effects of past exposures among retirees and of short-term effects of recent exposures among active employees. However, they cannot detect short-term effects of past exposures, and they have limited power for evaluating dose-response relationships.

Cause of Death↗
PubMed1989

A follow-up study of workers at a dye and resin manufacturing plant.

A total of 2642 men employed at a dye and resin manufacturing plant in New Jersey were observed from the opening of the plant in 1952 through 1985, and their mortality rates were compared with the rates of United States white men. The workers' mortality experience was related to former employment at the Cincinnati Chemical Works, which had produced or used benzidine and beta-naphthylamine. The 2553 men who had never worked at the Cincinnati Chemical Works had fewer than expected deaths from all causes combined (317 observed/402 expected) and equal numbers of observed and expected cancer deaths (89/89). The 89 former Cincinnati Chemical Works employees had an excess of cancer (17/8.6, P = .02), which was due to increased mortality from bladder (3/0.25, P = .004), kidney (2/0.21, P = .04), and CNS (2/0.22, P = .04) cancer. There also were several increases in cancers among men employed in certain work areas at the New Jersey plant. These included elevated mortality from lung (18/9.2, P = .01) and liver (3/0.46, P = .02) cancer among maintenance workers, from stomach (3/0.40, P = .02) and CNS (3/0.44, P = .02) cancer among azo dye workers, and from lung cancer (4/0.91, P = .03) among epichlorohydrin workers. The lung cancer excess among maintenance workers increased with length of employment, suggesting an association with an unidentified occupational exposure. Other associations were based on small numbers of deaths, and their interpretation is not clear.

Adult↗
PubMed1986

Carrots, green vegetables and lung cancer: a case-control study.

A total of 417 lung cancer cases and 849 controls were interviewed on their life-long tobacco usage and their current intake of four food items rich in retinol or carotene. The study was a hospital-based case control where 'cases' were lung cancer patients diagnosed during the period 1979/80 at seven hospitals in the Lombardy region (90% pathologically confirmed) and controls were patients admitted to the same hospitals for causes unrelated to tobacco smoking (epithelial cancers being excluded from present analysis). Odds ratios (OR) have been computed for increasing frequencies of consumption of liver, cheese, carrots and leafy green vegetables, having controlled for the confounding effects of tobacco usage, residence and birthplace. Current smokers who did not consume carrots showed a three-fold risk of developing lung cancer compared with those who ate them more than once a week (OR = 2.9 less than p less than 0.01); the ORs for consumers in the categories of 1-2 and 3-4 times per month were 1.8 and 2.0 respectively, with a significant test for linear trend (p less than 0.01). Among ex-smokers or non-smokers, no decrease of lung cancer risk is evident associated with carrot consumption. An excess risk was also associated with low intake of green vegetables although it was not significant, while no excess risk was evident for non-consumers of liver and cheese. The effect of carrots is independent of histological type of lung cancer while the effect of green vegetables was confined to epidermoid carcinomas: low versus high intake group OR = 1.3.

Diet↗
PubMed1982

Parity and breast cancer: confirmed evidence of an effect on age at diagnosis.

An evaluation is made of the hypothesis of Woods et al. (1) that the number of full-term pregnancies constitutes a factor of growth acceleration in breast cancer. Our results confirm, at least in part, the effect of parity on age at diagnosis of breast cancer. Patients with two or more children were significantly younger at the time of diagnosis than were those with none or one child. Age at first birth and duration of lactation do not seem to be, in this analysis, confounding factors for the observed association.

Adult↗
PubMedDate not supplied

Female condom use among women at high risk of sexually transmitted disease.

CONTEXT: Whereas the female condom has been evaluated in many hypothetical acceptability or short-term use studies, there is little information about its suitability for the prevention of sexually transmitted diseases (STDs) or HIV over extended periods of time. METHODOLOGY: As part of a six-month prospective follow-up study of 1,159 STD clinic patients, clients were interviewed during their initial visit, exposed to a behavioral intervention promoting condoms, given a physical examination and provided with instructions on completing a sexual diary. Potential predictors of trying the female condom were evaluated using logistic regression, and three condom-use groups (exclusive users of female condoms, exclusive users of male condoms and users of both types of condoms) were compared using multinomial regression. RESULTS: Among 895 women who reported having engaged in vaginal intercourse during the study period, one-half had sex with only one partner, while one-quarter each had two partners or three or more partners. A total of 731 women reported using the female condom at least once during the follow-up period--85% during the first month of follow-up. Multiple logistic regression analyses indicated that employed women and those with a regular sexual partner at baseline were significantly more likely to try the female condom. By the end of the follow-up period, 8% of participants had used the female condom exclusively, 15% had used the male condom exclusively, 73% had used both types of condom and 3% had used no condoms. Twenty percent of women who tried the female condom used it only once and 13% used it twice, while 20% used 5-9 female condoms and 32% used 10 or more. Consistent condom users (N=309) were predominantly users of both types of condom (75%), and were less often exclusive users of the male condom (18%) or the female condom (7%). According to a multivariate analysis, women who used the female condom exclusively or who mixed condom types were more likely to be black, were more likely to be employed and were more likely to have a regular partner than were users of the male condom. CONCLUSIONS: Women at risk of STDs find the female condom acceptable and will try it, and some use it consistently. Mixing use of female condoms and male condoms may facilitate consistent condom use. The female condom may improve an individual's options for risk reduction and help reduce the spread of STDs.

Adolescent↗
PubMedDate not supplied

Methylenetetrahydrofolate reductase (MTHFR) polymorphism increases the risk of cervical intraepithelial neoplasia.

Although cervical cancer is a common female cancer, little attention has been given to genetic susceptibility factors. The present case-control study was undertaken to examine MTHFR polymorphism as a potential molecular marker of cervical intraepithelial neoplasia (CIN) susceptibility and to relate the findings to smoking, HPV infection, ethnicity, parity and oral contraceptive use, which are known risk factors for cervical cancer. A base change from C to T at the nucleotide position 677 of the MTHFR gene results in substitution of valine (GTC) for alanine (GCC). The homozygous normal (Ala/Ala), homozygous mutant (Val/Val), and heterozygous mutant (Ala/Val) genotypes for the MTHFR gene were determined in cervical tissues of 64 cases of CIN lesions and 31 controls. The genotype frequencies of both Val/Val (17%) and Ala/Val (56%) were significantly higher in subjects with CIN lesions compared to controls with Val/Val (10%) and Ala/Val (39%), (trend p = 0.03). The results suggested a significantly increased CIN risk with an alanine to valine substitution at amino acid 223 of MTHFR with an odds ratio of 2.9 (95% confidence interval: 1.2-7.9, p = 0.02). Age, ethnicity, smoking and oral contraceptive use were weakly and nonsignificantly associated with CIN risk. HPV infection was associated with a statistically nonsignificant threefold increase in CIN risk. Parity and MTHFR genotype displayed a strong interaction. Neither nulliparous women with MTHFR polymorphism nor parous women without the polymorphism were at higher risk than women who did not have children and were MTHFR homozygous normal (the reference category). Women with mutant MTHFR genotype who had children, however, showed a significantly higher risk of CIN, with an odds ratio of 23 (95% confidence interval: 2.3-225) as compared to the reference category. No other factors displayed such a strong pattern of interaction. Since MTHFR polymorphism and pregnancy increases folate requirements and can impair folate status, this association could reflect an inadequate response of mutant MTHFR genotype carriers to the increased demand for folate imposed by pregnancy. Tissue folate deficiency, in turn, could increase the risk of CIN in the affected women.

Adult↗
PubMedDate not supplied

[The hemodialysed patient and his/her family caregiver. Comparison of perceptions of the chronic illness].

BACKGROUND: According to health psychology, the family caregiver (fc), i.e. the person who takes care of a hemodialysed patient, plays a pivotal role in coping with dialysis. This study explored and compared the lifestyle and the main needs of a cohort of hemodialysis patients, with reduced personal autonomy, to their fc, evaluating some psychological functional parameters, such as the perception of familial and social support, the psychological quality of life, the disability due to chronic illness, and the communication style. METHODS: An anonymous multiple versions questionnaire, administered according to the caregiver's family relationship, was given for self assessment to 54 couples of patients and related fc (spouse, son/daughter and brother/sister), mean age 66 and 60, respectively; mean dialytic patients' age: 8 years and 6 months. The questionnaire consisted of three different sections, demographics, renal disease and psychological evaluation, with 4 standard scales (Social Support Satisfaction, Marital Communication, Psychological General Well-Being Index and Evaluation of Needs). A multivariate variance analysis (MANOVA) was subsequently performed. RESULTS: Women have a higher perception of their lifestyle change after dialysis, and, in general, patients communicate more easily with their fc than vice versa. Communication problems are more common in patients with a recent diagnosis. Patients and fc mostly need a better dialogue with their nephrologists and urge some psychological help. CONCLUSIONS: The quality of the relationship between physicians, patients and their families is a key element in the process of healing.

Adult↗
PubMedDate not supplied

Folate deficiency and cervical dysplasia.

OBJECTIVE: To test the hypothesis that nutritional deficiency affects the incidence of cervical dysplasia in young women. DESIGN AND SETTING: Case-control study. Participants were derived from community family-planning clinics and referrals to a colposcopy center. PARTICIPANTS: A total of 726 subjects were screened, yielding 294 cases of dysplasia and 170 controls defined by coexistent cytologic and colposcopic evidence. MAIN OUTCOME MEASURES: Planned prior to data collection. Odds ratios were computed using logistic regression models to evaluate association between cervical dysplasia and sociodemographic, sexual, and reproductive factors; smoking; oral contraceptive use; human papillomavirus (HPV) infection; and 12 nutritional indices determined by blind analysis of nonfasting blood specimens. RESULTS: The number of sexual partners, parity, oral contraceptive use, and HPV-16 infection were significantly associated with cervical dysplasia. Plasma nutrient levels were generally not associated with risk. However, red blood cell folate levels at or below 660 nmol/L interacted with HPV-16 infection. The adjusted odds ratio for HPV-16 was 1.1 among women with folate levels above 660 nmol/L but 5.1 (95% confidence interval, 2.3 to 11) among women with lower levels. Interactions of red blood cell folate levels with cigarette smoking and parity were also present but were not statistically significant. CONCLUSION: Low red blood cell folate levels enhance the effect of other risk factors for cervical dysplasia and, in particular, that of HPV-16 infection.

Adolescent↗
PubMedDate not supplied

Validity of the mother's recall of her child's antibiotic use.

We compared the mother's recall of her child's antibiotic use with the information obtained from the child's health records, while studying the association between antibiotic use and prevalence of mutans streptococci among 102 (5-12 years) inner-city black children. Poor recall of the mother (concordance ratio = 62 percent; kappa = 0.18, p = 0.06) and the lower frequency reported by her (p = 0.02) biased the positive association between child's antibiotic use during the second year of life and oral presence of mutans streptococci toward the null value (Odds Ratio [OR] based on health records = 3.1, 95 percent Confidence Interval [CI] = 1.03-9.3; OR based on mother's recall = 1.6, 95 percent CI = 0.44-5.8). Multiple logistic regression analysis failed to identify any significant determinant of the accuracy of the mother's recall. Since mothers considerably underestimate child's use of antibiotics, at least among inner-city low income blacks, this method of data collection should be limited to circumstances where no other options are available, and such results should be interpreted with caution.

Adolescent↗
PubMedDate not supplied

A case control study of nutritional factors and cervical dysplasia.

The association of nutritional factors with cervical dysplasia was examined through a case-control study. Analysis was conducted in 257 cases and 133 controls confirmed both by cytological examination and colposcopic findings. A 24-h dietary recall questionnaire was used to assess nutritional intake. Various risk factors (including age at first intercourse, number of sexual partners, parity, cigarette smoking, oral contraceptive use, human papillomavirus type 16 infection, and age and race) were adjusted for their potential confounding effects. While analyses were also performed to adjust for total calories, results were not changed significantly. Among the nutrients examined, vitamin A intake showed a significantly increased risk at the lowest quartile compared to the highest quartile, with an odds ratio of 2.2 (95% confidence interval, 1.2-4.2). A significant trend of increasing risk was also observed with lower intake of vitamin A (P = 0.05). Riboflavin showed increased risk at the two lower quartiles of intake with a trend test P value of 0.04. Increased risk was also found for lower intakes of vitamin C compared to the highest intake level. For folate, increased risk was found in the second highest quartile compared with the highest quartile with an odds ratio of 2.0 (95% confidence interval, 1.0-3.8). The calcium:phosphorus ratio showed an increased risk at the lowest level (odds ratio, 2.0; 95% confidence interval, 1.0-4.3). Insufficient intake of vitamin A, riboflavin, ascorbate, and folate is associated with an increased risk of cervical dysplasia.

Adult↗
PubMedDate not supplied

Cigarette smoking, intracellular vitamin deficiency, and occurrence of micronuclei in epithelial cells of the buccal mucosa.

The study focuses on the assessment of chromosomal damage associated with folate and vitamin B12 deficiency, and with cigarette smoking in a tissue directly exposed to cigarette smoke (buccal mucosa) while controlling for potential confounding factors. A cross-sectional study was carried out among 39 current smokers (CSs) and 60 noncurrent smokers (NCSs). Buccal mucosal cells, saliva, and blood samples were collected from each subject. The Health Habits and History Questionnaire (Block et al., 1986) was modified to obtain dietary and other relevant information. Methods used to measure folate, vitamin B12 levels, and the frequency of micronucleated cells in buccal mucosal cells gave reproducible results. The study results suggest that CSs have buccal mucosal folate and vitamin B12 levels that are lower than those among NCSs. CSs were three times more likely to have micronucleated buccal mucosal cells compared to NCSs. There appeared to be no association between low buccal folate and vitamin B12 levels chromosomal damage. The salivary vitamin B12 concentrations and plasma vitamin C and E concentrations, however, seem to be marginally protective against the occurrence of buccal mucosal micronuclei, whereas plasma beta-carotene seems to increase the occurrence of micronuclei. Overall, the results do not support the concept that localized folate and vitamin B12 deficiencies in the buccal mucosal cells of smokers are associated with chromosomal damage in those cells. The presence of vitamin B12 deficiencies in the buccal mucosal cells of smokers are associated with chromosomal damage in those cells. The presence of vitamin B12 in the immediate environment (saliva) and vitamin C and E in the plasma, however, appear to be marginally protective against chromosomal damage in buccal mucosal cells.

Adult↗