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Biomedical subjects

P Maisonneuve

Publications and source records attributed to P Maisonneuve.

At least 19 recordsLinked to original sources
PubMed1996

Cancer among patients on renal replacement therapy: a population-based survey in Lombardy, Italy.

Longer and better survival of End-Stage Renal Disease (ESRD) patients undergoing renal replacement therapy (RRT) is now associated with a higher prevalence of new elderly patients receiving renal replacement therapy (dialysis). In order to help clarify the association of cancer risk with RRT, the incidence of cancer in a population-based cohort of uraemic patients in the Region of Lombardy, northern Italy, was undertaken using data from the Lombardy Regional Dialysis and Renal Transplant Registry. A total of 479 cases of cancer of all sites was recorded in this population. There were statistically significantly elevated risks of primary liver cancer, kidney cancer, thyroid cancer, lymphoma and multiple myeloma. When the data were examined according to primary renal diseases, there did not appear to be any particular association between excess cancer risk and the underlying pathology. While some caution must be expressed in interpreting these data, due to the relatively small numbers of cases expected in many of the disease entities, the results indicate an excess of renal-cell and liver carcinomas and lymphomas in patients receiving RRT and highlight the necessity of careful follow-up and awareness of these associations, together with the need for early detection of such tumours.

Aged↗
PubMed1996

Decrease in mortality from benign prostatic hyperplasia: a major unheralded health triumph.

PURPOSE: A systematic examination of all available mortality data from benign prostatic hyperplasia (BPH) between 1950 and 1990 was done to estimate the changing international mortality pattern of this condition. MATERIALS AND METHODS: Mortality data in which BPH was the underlying cause of death were abstracted from the World Health Organization mortality data base. These data were available from a variety of international countries (in many since 1950). RESULTS: Mortality rates have decreased with considerable magnitude in developed western countries between the early 1950s and late 1980s. This fact could reasonably be attributed to the improved management of the most severe complications of BPH and to improvements in surgery and anesthesia, which have made surgical interventions of the prostate possible in a greater proportion of men, and safer in the immediate and subsequent postoperative period. CONCLUSIONS: The decreases noted in western countries, such as the United Kingdom (where 8,700 fewer men die each year presently than would be expected if the BPH mortality rates from the early 1950s still applied), United States (13,681 fewer deaths) and France (2,884 fewer deaths), indicate a considerable but unheralded achievement for modern medicine. Unfortunately, these decreases have not been observed to the same extent in central and eastern Europe and South America, where the residual high mortality rates could be lowered by education, and the widespread availability of modern surgical and anesthetic equipment.

Cause of Death↗
PubMed1995

The risk of cancer among patients with cystic fibrosis. Cystic Fibrosis and Cancer Study Group.

BACKGROUND: Anecdotal reports suggest an increased frequency of certain cancers in patients with cystic fibrosis, the commonest genetic disorder of whites. One third of patients with cystic fibrosis now reach adulthood, when cancer is more frequent, implying that cancer rates in these patients will increase over time. We investigated the relation between cystic fibrosis and cancer in North American and European patients with cystic fibrosis. Methods. We performed a retrospective cohort study of the occurrence of cancer in 28,511 patients with cystic fibrosis from 1985 through 1992 in the United States and Canada. The number of cases observed was compared with the number expected, calculated from population-based data on the incidence of cancer. We also analyzed proportional incidence ratios to assess the association between specific cancers and cystic fibrosis in Europe. RESULTS: Thirty-seven cancers were observed in the North American cohort during 164,764 person-years of follow-up, as compared with an expected number of 45.6, yielding a ratio of observed to expected cancers of 0.8 (95 percent confidence interval, 0.6 to 1.1). Thirteen digestive tract tumors were observed, as compared with an expected number of two, for a ratio of observed to expected cancers of 6.5 (95 percent confidence interval, 3.5 to 11.1). In Europe, 11 of 39 cancers originated in the digestive tract, yielding a positive association between digestive tract tumors and cystic fibrosis (odds ratio, 6.4; 95 percent confidence interval, 2.9 to 14.0). CONCLUSIONS: Although the overall risk of cancer in patients with cystic fibrosis is similar to that of the general population, there is an increased risk of digestive tract cancers. Persistent or unexplained gastrointestinal symptoms in these patients should be carefully investigated.

Adolescent↗
PubMed1995

Lung cancer and tobacco smoking.

The dominant role of tobacco smoking in the causation of lung cancer has been repeatedly demonstrated over the past 50 years. Current lung cancer rates reflect cigarette smoking habits of men and women in the past decades, but not necessarily current smoking patterns, since there is an interval of several decades between the change in smoking habits in a population and its consequences on lung cancer rates. Over 90% of lung cancer may be avoidable simply through avoidance of cigarette smoking. There is at present a huge premature loss of life world-wide caused by smoking. Rates of lung cancer present in central and eastern Europe at the present time are higher than those ever before recorded elsewhere; lung cancer has increased 10-fold in men and eightfold in women in Japan since 1950. There is a world-wide epidemic of smoking among young women which will be translated into increasing rates of tobacco-related disease, including cancer, in the coming decades. There is another epidemic of lung cancer and tobacco-related deaths building up in China as the cohorts of men in whom tobacco smoking became popular reach ages where cancer is an important hazard. Many solutions have been attempted to reduce cigarette smoking and increasingly many countries are enacting legislation to curb this habit. Cigarette smoking remains the number one target for Public Health action aimed at reducing cancer risk in the general population. General practitioners, hospital physicians and everyone working in oncology have a particularly important exemplary role to play in this process.

Female↗
PubMed1995

Worldwide patterns of prevalence and mortality from benign prostatic hyperplasia.

Benign prostatic hyperplasia (BPH) can be found in 88% of autopsies in men > or = 80 years, with compatible symptomatology reported in nearly 50% of men aged > or = 50 years in the general population. Despite such a common occurrence, little is known with any certainty about the epidemiology of BPH (for which "prostatism" is a commonly, and wrongly, used synonym). Knowledge of risk factors is sparse: analytic epidemiologic studies of BPH are difficult to conduct. It is essential to establish an epidemiologic definition of BPH for these reasons. Both BPH and prostatism are the problems that seem set to increase in absolute terms. They are clearly identified as priority areas for research into their causes and treatment. However, it is clear that there is a great need for more epidemiologic information, particularly regarding prostatism, whose occurrence is unknown in many parts of the world.

Global Health↗
PubMed1995

Geographical and temporal patterns of incidence and mortality from prostate cancer.

In many countries of the world, prostate cancer is the second most common form of cancer in men, and in the United States it is now in first rank. It is an important public health problem, with > 0.25 million new cases diagnosed worldwide in the year 1985. Whereas earlier large increases in the incidence of prostate cancer were apparent throughout the world, the mortality rate has remained constant in generations of men born since the early years of this century. Most importantly, given that in several countries the increased number of children born after World War II will be in their mid-50s in the early part of the 21st century (at an age when cancer risk is becoming an important consideration), and coupled with the trends in increasing life expectancy, the consequence will be an increase in absolute terms in the number of cases of prostate cancer diagnosed. In the absence of treatment improvements and with prospects for prevention by modification of lifestyle remote within current knowledge, there will also be an increase in the number of deaths from prostate cancer worldwide. The situation would be further augmented by the presence of a temporal trend in risk that is widely reported from many countries and unlikely to be entirely artefact.

Age Factors↗
PubMed1995

A comparative evaluation of the sensitivity of seven anti-hepatitis C virus screening tests.

The sensitivity of the most recent generation of anti-hepatitis C virus (anti-HCV) screening tests from seven manufacturers was evaluated with a common panel of 530 specimens from 320 HCV-infected subjects. This panel included 221 samples from 57 seroconverters (53 pre-sero conversion negative specimens and 168 positive samples) and 309 selected specimens from 263 other HCV-infected patients of which 19% exhibited NS3 or core reactivity alone with the presence of HCV-RNA assessed by PCR. None of the seven screening tests detected all infectious and antibody-positive specimens. However, important differences were observed between these assays in the number of false-negative results, which seemed mainly due to nonreactivity of antibody to the NS3 antigen.

Antigen-Antibody Reactions↗
PubMed1995

[Prevalence and risk factors of hepatitis C virus infection in a hospitalized population in a gastroenterology unit. Role of endoscopic biopsies].

OBJECTIVES AND METHODS: In order to study the prevalence and risk factors of HCV infection in a population hospitalized in a Gastroenterology Unit, 3,767 patients were tested for serum anti-HCV, and 2,607 filled out a questionnaire about risk factors. RESULTS: With the RIBA 2 test, the overall prevalence was 5.9%. Because of the age distribution, two populations were studied. In patients younger than 45, intravenous drug use was the only independent risk factor linked to serum anti-HCV positivity (Odds ratio: 151, CI 95%: 66.9-340). In patients older than 45, the independent risk factors were chronic liver disease (Odds ratio: 8.5, CI 95%: 4.4-16.8), per-endoscopic biopsies (Odds ratio: 2.7, CI 95%: 1.4-5.4), and blood transfusions (Odds ratio: 1.8, CI 95%: 0.9-3.5). Two variables were dominant for the entire population: IV drug use and chronic liver disease. In patients without these factors, only one risk factor was linked to serum anti-HCV positivity: perendoscopic biopsies (Odds ratio: 5.2, CI 95%: 1.6-16.5). CONCLUSION: These results suggest that HCV may be transmitted by perendoscopic biopsies.

Adult↗
PubMed1994

Dietary fat, olive oil intake and breast cancer risk.

As part of a population-based case-control study on diet and breast cancer in Spain, the role of dietary fat and vegetable oils in breast cancer etiology was examined. A validated, semi-quantitative food-frequency questionnaire was completed by 762 women, 18-75 years of age, with histologically confirmed, newly diagnosed breast cancer, and 988 randomly selected female controls. For each food item and nutrient, the study subjects were divided into quartiles according to intake levels, with the lowest quartile serving as the reference category. Adjustment for total energy intake and other potential confounders was made using multiple logistic regression for all women as well as separately for pre- and post-menopausal women. Neither total fat intake nor specific types of fat were significantly associated with breast cancer in pre- or post-menopausal women. However, higher consumption of olive oil (rich in monounsaturated fat) was significantly related to a lower risk of breast cancer [for highest vs. lowest quartile of consumption, odds ratio (OR) = 0.66; 95% CI, 0.46-0.97] with a significant dose-response trend. While these findings do not support a relation between total fat intake and breast cancer risk, they do provide evidence for an inverse association between olive oil (and suggest one between monounsaturated fat) and risk of breast cancer.

Adolescent↗
PubMed1994

Mothers' active and passive smoking during pregnancy and risk of brain tumours in children.

As part of a collaborative study of risk factors for childhood brain tumours, the effects of the mother's smoking and her potential for passive smoking exposure during the pregnancy were assessed in a case-control study. Parents of 91 cases and 321 population controls from Northern Italy, matched for age, sex and residence, were interviewed about their lifetime smoking habits. Mother's smoking during pregnancy was associated with an odds ratio (OR) of 1.7 (95% CI 0.8, 3.8) of brain tumour in her child although this was not statistically significant. Among non-smoking mothers, the risk for light and heavy exposure to passive smoking was 1.7 (0.8, 3.6) and 2.2 (1.1, 4.5) respectively, and a statistically significant dose-response relationship was found (p trend = 0.02). These results must be interpreted within the constraints of the relatively small sample size and the likely misclassification produced by the difference between the potential for exposure to passive smoke and the true exposure. However, they add another piece of information to the growing body of evidence available about the health consequences both of active and of passive smoking and highlight the need for more information about this putative association.

Adolescent↗
PubMed1994

Antenatal risk factors for malignant brain tumours in New South Wales children.

A population-based case-control study of incident primary malignant brain tumours diagnosed during 1985 to 1989 in children aged 0 to 14 years was carried out in the coastal conurbation of New South Wales comprising Sydney, Wollongong and Newcastle in the period 1988 to 1990. Personal interviews were conducted using a structured questionnaire with mothers of 82 cases and 164 control children individually matched to the cases by sex and age. Among the hypotheses being examined were those related to exposure to parental tobacco smoke, N-nitroso compounds and possible protection from sources of vitamin C. No link was found with tobacco smoking by the mother before or during pregnancy. While exposure during pregnancy of the mother to tobacco smoke of the father appeared to double the risk of childhood brain tumours and a similar risk was found for father (but not mother) smoking before the index pregnancy, there was no "dose-response" and the increased risk was confined to data supplied by the mother (rather than the father himself). The risk of childhood brain tumours rose with reported increasing consumption, during pregnancy, of cured meats, which have high levels of N-nitroso compounds (or their precursors), and fell with rising consumption of vegetables. No association was found between the risk of childhood brain tumours and family history of epilepsy, cancer, or tumours of the nervous system, parental irradiation, previous miscarriage or procedures carried out during pregnancy, maternal consumption of antihistamines, barbiturates or diuretics, or maternal contact with cats or farm-life during pregnancy.

Adolescent↗
PubMed1994

Perinatal and early postnatal risk factors for malignant brain tumours in New South Wales children.

A population-based case-control study of incident primary malignant brain tumours diagnosed during 1985-1989 in children aged 0 to 14 years was carried out in the coastal conurbation of New South Wales comprising Sydney, Wollongong and Newcastle in the period 1988 to 1990. Personal interviews were conducted using a structured questionnaire with mothers of 82 cases and 164 control children individually matched to the cases by sex and age. Among the hypotheses examined were those related to: N-nitroso compounds (sources included diet, dummies, medications, tobacco smoke); factors associated with the birth of the child; trauma to the head; and irradiation (X-rays and electromagnetic radiation through electric blankets or water beds). Reported ever-use of a dummy increased the risk of childhood brain tumours (OR = 2.9, 95% CI 1.6 to 5.4), although there did not appear to be any consistent indication of rising risk with reported increased levels of use. Compared with children who had never used a dummy, categories of use during the first year of life of a maximum of "no more than 1 hour per day or night", "several hours per day or night", and "most of the day or night" had statistically significant odds ratios of 2.6, 3.4, and 2.7 respectively. Consumption of fruit by the child before the age of one appeared to be protective. No association was found between childhood brain tumours and birth weight, being the first-born child, or factors linked with the child's birth; head injuries; exposure to X-rays; contact with horses, or living on a farm; pesticide treatment of the house during the child's lifetime; or exposure to burning incense.

Adolescent↗
PubMed1994

Some statistical considerations in the analysis of case-control studies when the exposure variables are continuous measurements.

This paper focuses on some statistical considerations in the estimation of dose-response in case-control studies when the exposure variables are continuous measurements. The first point is that the effects of differential variability in the exposure distributions over cases and controls cannot be differentiated from a true quadratic risk model. The second point is that when dealing with variables where zero denotes no exposure, it is important to treat the unexposed subjects separately from those who were exposed. Failure to do so can lead to differential variability among cases and controls and the resulting confounding with a quadratic risk model. Both of these points are illustrated by an example.

Case-Control Studies↗