Biomedical subjects
Paul Gargiullo
Publications and source records attributed to Paul Gargiullo.
Population-based statistics for women diagnosed with inflammatory breast cancer (United States).
OBJECTIVE: The purpose of this study was to use population-based information to describe the demographic and tumor characteristics of inflammatory breast cancer (IBC) - the most aggressive form of this disease. METHODS: IBC cases diagnosed during 1994 through 1998 were reported to 26 population-based cancer registries covering approximately 40% of the US population. Rates were expressed per 100,000 female population and age-adjusted to the 2000 US population. Ninety-five percent gamma confidence limits were estimated for the rates. RESULTS: Among the 3626 women diagnosed with IBC during 1994-1998, the majority were 40-59 years old. Most tumors were diagnosed at a regional (68.9%) or distant (25.3%) stage and were poorly differentiated (49.4%). The rate of IBC was 1.3 per 100,000 for all races combined. Black women had the highest risk (1.6) and Asian and Pacific Islander women the lowest (0.7). CONCLUSIONS: IBC is an extremely rare form of breast cancer. More precise diagnostic criteria are needed to distinguish it from less aggressive forms of the disease. Future studies should use a population-based design and collect detailed clinical information, including the presence of erythema, edema or peau d'orange appearance of the skin, and other clinical signs of disease.
Wheezing lower respiratory disease and vaccination of full-term infants.
PURPOSE: There have been speculations that increases in vaccinations have caused recent increases in wheezing lower respiratory disease during infancy. We assess possible associations between vaccines and incidence of wheezing in full-term infants. METHODS: We conducted a matched case-control study of full-term infants born into the Kaiser Permanente Northwest health plan during 1991-1994 and continuously enrolled for at least 12 months (n = 1366 case-control pairs). Potential cases of wheeze were ascertained from medical care databases and verified by chart review. Vaccinations, demographic factors, and wheeze risk factors were abstracted from charts. Adjusted relative risks of first onset of wheeze during post-vaccination exposure windows were estimated by conditional logistic regression. We also conducted case-series analyses of wheeze onsets. RESULTS: We found no evidence that risk of wheeze during infancy is associated with recency of vaccination with whole-cell pertussis (DTP), hepatitis b (HBV), Haemophilus influenzae type b (HIB), oral polio (OPV), or measles, mumps and rubella (MMR) vaccines. We also found no evidence that risk of first wheeze is associated with exposure to HBV or MMR. CONCLUSIONS: Recent increases in wheezing during infancy do not appear to be related to increases in vaccinations of full-term infants.