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Biomedical subjects

R Dubrow

Publications and source records attributed to R Dubrow.

At least 55 records · Page 3Linked to original sources
PubMed1994

Malignant melanoma incidence in Connecticut (United States): time trends and age-period-cohort modeling by anatomic site.

This study examined time trends and age-period-cohort patterns in the incidence of cutaneous malignant melanoma (CMM) by gender and anatomic site in Connecticut (United States) between 1950 and 1989, using data from the population-based Connecticut Tumor Registry. A total of 8,249 invasive CMM incident cases were included. Cases were grouped into melanomas of the head and neck, upper limb, lower limb, and trunk. Between 1950 and 1989, rates increased substantially for all sites. The largest relative increases occurred in melanoma of the upper limb for both males and females; the largest absolute increase occurred for melanoma of the trunk in males; and the smallest increase occurred in head and neck melanoma in females. Recent trends for time periods 1970-89 among birth cohorts 1930-69 indicated that the rate of increase of CMM is slowing substantially among males, but not among females. Nevertheless, continued overall increases in CMM incidence are likely in Connecticut in the 1990s in both genders, with a decrease in the male-female ratio. The age-period-cohort patterns were significantly different between the genders and among anatomic sites, suggesting different trends in carcinogenic exposures (mainly ultraviolet radiation from the sun) or etiologic distinctions between males and females and among the sites.

Adult↗
PubMed1993

Intra-uterine contraception and the risk of endometrial cancer.

Despite the increasing world-wide popularity of contraceptive intra-uterine devices (IUDs), their potential long-term effects on the risk of developing endometrial carcinoma have been poorly studied. This paper reports on the relationship between intra-uterine contraception and endometrial cancer by analyzing epidemiological data from a large, multicenter, population-based, case-control study of epithelial endometrial cancer. Cases were 437 women, 20 to 54 years of age, with histologically confirmed epithelial endometrial cancer ascertained through 6 population-based cancer registries in the United States. Controls were 3200 women selected at random from the populations of these areas. The age- and parity-adjusted odds ratio (OR) for the association between ever having used intra-uterine contraception and endometrial cancer was 0.51 (95% confidence interval (CI) 0.3-0.8). Although the protective effect increased with duration of use, a dose-response relationship among users was not statistically demonstrable. The association did not vary significantly with age at first or last IUD use or with time elapsed since first or last IUD use. Years of education significantly modified the effect of intra-uterine contraception. Thus, intra-uterine contraception appeared to be strongly protective for women with at least 13 years of education (OR = 0.29, 95% CI, 0.15-0.6). It is proposed that intra-uterine contraception exerts its protective effect through local structural and biochemical changes in the endometrium that may alter endometrial sensitivity and response to circulating estrogen and progesterone.

Adult↗
PubMed1993

Age-period-cohort modelling of large-bowel-cancer incidence by anatomic sub-site and sex in Connecticut.

In order to investigate etiologic distinctions among the anatomic sub-sites of the large bowel by sex, the relationship between large-bowel-cancer incidence and age at diagnosis, time period at diagnosis, and birth cohort was analyzed by anatomic sub-site and by sex, using data from the Connecticut Tumor Registry. Included in the study were all incident large-bowel-cancer cases occurring between 1950 and 1984 among Connecticut residents aged 40 to 79. Cancers of the large bowel were classified into 5 anatomic sub-sites: ascending colon (including cecum), transverse colon (including flexures), descending colon, sigmoid colon, and rectum (including rectosigmoid junction, anal canal, and anus). The data were fitted to log-linear age-period-cohort models. For each of the sub-sites, the age-period-cohort patterns for males and females differed. Within each sex, sub-site groupings with common patterns were indicated. Among males, the age-period-cohort patterns for the colon sub-sites were fairly similar; but the pattern for the rectum differed markedly from that for the colon sub-sites. There were secondary differences among the colon sub-sites that pointed to a secondary distinction between the right and the left colons. Among females, the age-period-cohort patterns for the left colon sub-sites and the rectum were fairly similar. The pattern for the transverse colon differed moderately from that of the left colon, and differed substantially from that of the rectum and the ascending colon. The ascending colon differed markedly from each of the other sub-sites. It is possible that these differences in age-period-cohort patterns reflect etiologic distinctions among sub-site groupings and between the sexes.

Adult↗
PubMed1993

A hospital-based case-control study of breast-cancer risk factors by estrogen and progesterone receptor status.

It has been proposed that breast cancers may differ in their pathogenesis and etiology according to their estrogen receptor (ER) and progesterone receptor (PR) status. This hospital-based case-control study in Japan assessed the relationship between known and suspected breast-cancer risk factors and ER and PR status. Information on risk factors was collected from histologically confirmed breast-cancer cases (n = 519) and from cancer-free controls (n = 9,506). Of 160 cases with known ER status, 58 percent were ER-positive; 38 percent of 157 cases with known PR status were PR-positive. No statistically significant differences were found between ER-positive cf ER-negative cases. However, statistically significant differences between PR-positive cf PR-negative cases were observed for number of full-term pregnancies (P = 0.01), menstrual regularity as a teenager (P = 0.024), and occupation as housewife (P = 0.036). Borderline differences were observed for age at menopause (P = 0.074), and age at menarche (P = 0.083). This study provides some evidence that etiologic distinctions may be greater between PR-positive and PR-negative breast cancers than between ER-positive and ER-negative breast cancers.

Adult↗
PubMed1992

Association between childhood rhabdomyosarcoma and maternal history of stillbirths.

A case/control study of childhood rhabdomyosarcoma (RMS) was conducted utilizing information from birth records. Cases among Connecticut residents age 19 and younger diagnosed between 1960 and 1988 were identified from the Connecticut Tumor Registry files. Connecticut birth certificates were located for 103 of the 130 cases identified. A random sample of control birth certificates was frequency-matched to the cases by year of birth, sex, and ethnic origin, with a control:case ratio of 2:1. Information abstracted from birth certificates included birth weight, length of pregnancy, plurality, birth order, mother's prior stillbirths, mother's age, father's age, and father's occupation. Data were analyzed by conditional logistic regression. The major finding was an association between RMS and the mother having had one prior stillbirth or more (odds ratio = 3.7; 95% confidence interval = 1.5 to 8.9). Particularly noteworthy was the observation that 6 mothers of cases, but no mothers of controls, had had 2 or more prior stillbirths. The trend for increasing risk of RMS with increasing number of mother's prior stillbirths was highly significant (p = 0.0004). This association suggests that RMS and a class of stillbirths share a common etiologic factor. This factor may be genetic or may involve in utero exposure to an exogenous or endogenous agent.

Birth Weight↗
PubMed1992

Gastrin and colorectal cancer. Evidence against an association.

Plasma gastrin has been reported to be elevated among patients with colorectal cancer. The objectives of the present study were to confirm this observation and, if confirmed, to shed light on the reason for the elevation. Presurgical and postsurgical fasting plasma gastrin levels were compared between 24 patients hospitalized for colorectal adenocarcinoma resection and 25 control patients hospitalized for other surgery. Elevated presurgical gastrin levels in the case group that fell after surgery would be consistent with production of gastrin by the tumor. High presurgical gastrin levels in the case group that did not change following surgery would be consistent with excess gastrin production by G cells. The mean presurgical gastrin levels were 21.9 +/- 3.7 pM (cases) and 45.1 +/- 18.0 pM (controls). The mean postsurgical gastrin levels were 20.5 +/- 3.9 pM (cases) and 43.4 +/- 14.6 pM (controls). These results do not provide support for the hypotheses that gastrin is elevated in colorectal cancer patients or that gastrin is secreted by colorectal tumors in sufficient quantities to be measurable in the plasma.

Adenocarcinoma↗
PubMed1992

Fecal lysozyme: an unreliable marker for colorectal cancer.

High levels of lysozyme have been reported to be present in the feces of patients with colorectal cancer. It has been suggested that fecal lysozyme could prove useful in the early detection of colorectal cancer, but that further work is needed. The present investigation reports on the measurement of fecal lysozyme in 23 colorectal cancer patients and 39 healthy controls. The mean fecal lysozyme level for the cases was 13.3 +/- 2.8 micrograms/g stool compared with 12.5 +/- 2.6 micrograms/g stool for the controls. The median level for the cases was 8.7 micrograms/g stool compared with 6.6 micrograms/g stool for the controls. Forty-three percent of the cases and 31% of the controls had fecal lysozyme levels above 10 micrograms/g stool. None of these differences were statistically significant. The results of this study indicate that fecal lysozyme would be of no use in the early detection of colorectal cancer.

Adenoma↗
PubMed1992

Fecal protein markers of colorectal cancer.

To identify fecal proteins that might prove useful in the early detection of colorectal cancer, we used sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and protein immunoblotting to compare the fecal protein patterns of stool supernatants from 10 patients with colorectal cancer with those of 12 controls. SDS-PAGE followed by Coomassie blue staining revealed two heavily stained bands in the majority of cancer stools that were not present in control stools. These bands proved to be human hemoglobin and human albumin by protein immunoblotting. No other consistent differences between the cancer and control stools were observed on the stained gels. The stool supernatants were probed for several other blood proteins by protein immunoblotting. Carbonic anhydrases I and II were more abundant in the cancer stools; alpha 1-antitrypsin appeared equally in cancer and control stools. Further work is needed to determine whether measurement of fecal carbonic anhydrase can be useful for early detection of colorectal cancer.

Adult↗
PubMed1991

Time trends in malignant melanoma of the upper limb in Connecticut.

Time trends in the incidence of malignant melanoma of the anatomic subsites of the upper limb in Connecticut from 1935 to 1984 were examined. Among males, the incidence of melanoma of the hand was stable, in sharp contrast to the 15-fold to 16-fold increase in the upper arm and forearm. Among females, the 3-fold increase in melanoma of the hand was substantially less than the 12-fold to 14-fold increase in the upper arm and forearm. However, melanoma of the dorsal surface of the hand in females increased sevenfold. These results are in partial agreement with the hypothesis that the hand would be relatively resistant to increased melanoma incidence because it has continually been a sun-exposed site over the decades. The results contradict the hypothesis that the rise in incidence would be greater in the upper arm (a usually unexposed site that has received increasing exposure due to changes in recreation and dress habits) than in the forearm (a site of intermediate exposure).

Arm↗
PubMed1991

Fecal carriage of Streptococcus bovis and colorectal adenomas.

An association between fecal carriage of Streptococcus bovis and colorectal carcinoma has been reported. A relationship between S. bovis and colorectal adenomas has also been suggested. In the present study, the relationship between S. bovis and adenomas was investigated. Two of 18 current adenoma patients (11%) were found to have S. bovis in their stool compared with 12 of 84 controls (14%). Six of 38 patients who had ever had a diagnosis of adenoma (16%) had S. bovis compared with 8 of 64 controls (13%). These results rule out a strong association between fecal carriage of S. bovis and adenomas; however, because of the relatively small sample size, a weak to moderate association cannot be excluded.

Adenoma↗
PubMed1988

Cause-specific mortality among male textile workers in Rhode Island.

Cause-specific mortality patterns among male textile workers in Rhode Island who died during the period 1968-1978 were examined using the proportionate mortality ratio (PMR) method. Textile worker decedents were identified by the usual occupation and industry statements on Rhode Island death certificates. A statistically significant PMR elevation was observed for nonmalignant respiratory disease (NMRD) among male textile workers (PMR = 110; Observed deaths [Obs] = 433; 95% confidence interval (CI) = 102-120). The PMRs for NMRD by specific textile occupation and by type of textile manufacturing generally exhibited the pattern expected for work-related mortality owing to textile dust exposure. High PMRs were observed among carding, lapping, and combing operatives, the decedents who probably had the highest dust exposure (PMR = 166; Obs = 24; CI = 114-243), and among operatives most likely to have worked in cotton manufacturing (PMR = 137; Obs = 47; CI = 104-179). This is the first report of excess mortality from NMRD among male textile workers in the United States. This finding is consistent with previous evidence that exposure to cotton dust can cause disabling chronic lung disease. Also noteworthy were statistically significant elevated PMRs for cancers of the rectum and esophagus among decedents who had been engaged in textile dyeing and finishing. Owing to the lack of direct information about occupational exposures and smoking habits of the decedents and uncertainties in classifying decedents by type of textile manufacturing, this investigation should be viewed as being exploratory in nature.

Adult↗
PubMed1988

Ischemic heart disease and acute myocardial infarction mortality among police officers.

The relationship between the occupation of police officer and ischemic heart disease (IHD) mortality was examined through case-control studies using 1968/78 death certificate records from Rhode Island and Utah. IHD was divided into two subcategories--acute myocardial infarction (AMI) and other IHD. In both states, the odds ratio (OR) for AMI was significantly elevated (Rhode Island, OR = 1.3; Utah, OR = 1.8), and was higher than the OR for other IHD (Rhode Island, OR = 1.1; Utah, OR = 1.4). The odds ratio for AMI was higher in the less than 65 yr age group (Rhode Island, OR = 2.1; Utah, OR = 2.1) than in the greater than or equal to 65 yr age group (Rhode Island, OR = 0.9; Utah, OR = 1.6). These results suggest that the elevated risk for IHD among police officers observed in this and other studies is primarily due to an elevated risk for AMI. The pattern of diminishing risk with age suggests a risk factor, possibly stress, the effect of which diminishes when exposure ceases at retirement.

Adult↗
PubMed1988

Farming and malignant lymphoma in Hancock County, Ohio.

Raised death rates have been reported for non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) among white male residents of Hancock County, Ohio, United States, for 1960-79. As a surveillance activity, to assess the possibility of workplace exposures contributing to these raised rates, a case-control study was conducted using death certificate records of white male Hancock County residents for 1958-83. There were 61 cases of NHL, 15 cases of HD, and 304 control subjects (chosen as a stratified random sample) in the study. Cases and controls were compared with respect to their usual occupation and industry statements on the death certificates, adjusting for age at death and year of death. Summary odds ratios (OR) and test-based 95% confidence intervals (CI) were calculated. NHL was associated with the occupation of farmer (OR = 1.6; CI = 0.8, 3.4; observed number of exposed cases (Obs) = 15). The association was restricted to 1958-73 (OR = 2.1; CI = 0.9, 4.8; Obs = 13). The three cases of HD among farmers occurred in a cluster in the 15-64 age range during 1958-63 (OR = 21.2). The results for occupations and industries other than farming were based on small numbers and were unremarkable. This small study adds to the growing body of reports linking farming and malignant lymphoma, particularly NHL.

Agricultural Workers' Diseases↗
PubMed1988

Suicide among social workers in Rhode Island.

Cause-specific mortality patterns, by occupation, were examined among Rhode Island residents who died during the period 1968-1978, using the age-standardized proportionate mortality ratio (PMR) method. Occupation was determined from the usual occupation statement on the death certificate. A noteworthy finding was an elevated PMR for suicide among both male (PMR = 470, observed deaths = 5, P less than .01) and female (PMR = 510, observed deaths = 4, P less than .05) social workers. This is the first report of a high risk of suicide among social workers. Stress, which is associated with social work, may be a risk factor. Due to the relatively small numbers upon which this report is based and the limitations of death certificate data and the PMR method, this should be viewed as an exploratory investigation requiring further follow-up.

Adult↗
PubMed1987

Death certificate-based occupational mortality surveillance in the United States.

Surveillance of cause-specific mortality patterns by occupation and industry through the use of death certificate records is a simple and relatively inexpensive approach to the generation of leads as to potential occupational disease problems. Researchers from the National Institute for Occupational Safety and Health (NIOSH) have been working with the National Center for Health Statistics, other federal agencies, and state health departments on a number of programs to foster the development of standardized, routine coding of occupation and industry entries on death certificates by state health departments. Thirty-one states and the District of Columbia are now doing such coding. These data are being analyzed currently by investigators at NIOSH and at individual state health departments for the purpose of hypothesis generation on occupation-disease relationships. The proportionate mortality ratio method is the predominant method being used, as appropriate denominator data are not generally available. This type of surveillance is particularly useful for the study of occupation and industry groups for which it is difficult to assemble cohorts, such as groups that are predominantly non-union and in small workplaces. Limitations of this surveillance include its inappropriateness for monitoring those occupational diseases which are not often fatal, and the limited scope and accuracy of death certificate information.

Death Certificates↗
PubMed1987

Cause-specific mortality among Rhode Island jewelry workers.

Cause-specific mortality patterns among Rhode Island jewelry manufacturing workers, as identified on death certificates from 1968 to 1978, were examined using the proportionate mortality ratio (PMR) method. Among males, elevated PMRs were observed for nonmalignant kidney disease (PMR = 163; Observed deaths [Obs] = 19; p less than or equal to .05), liver cancer (PMR = 297; Obs = 6; p less than or equal to .05), drug dependence (PMR = 379; Obs = 5; p less than or equal to .05), and accidental poisonings (PMR = 274; Obs = 8; p less than or equal to .05). All but one of the deaths from accidental poisonings involved drugs or drugs and alcohol. Among females, elevated PMRs were observed for stomach cancer (PMR = 174; Obs = 20; p less than or equal to .01), peptic ulcer (PMR = 235; Obs = 8; p less than or equal to .05), diseases of the skin and subcutaneous tissue (PMR = 383; Obs = 5; p less than or equal to .05), and drug dependence (PMR = 674; Obs = 3; p less than or equal to .05). Exposure to known renal toxins (heavy metals and solvents) used in the jewelry industry may account for the excess deaths from kidney disease. The elevated PMR for liver cancer may be due to exposure to solvents (trichloroethylene, perchloroethylene, carbon tetrachloride) that cause liver cancer in animals. The elevated PMRs for drug dependence and accidental poisonings may be due to the socioeconomic status of jewelry workers, or to the interaction between solvents used in jewelry manufacturing and drugs, or drugs and alcohol. Because of the lack of information about the specific occupational exposures of the decedents, this should be viewed as an exploratory investigation requiring further follow-up.

Cause of Death↗
PubMed1986

Malignant melanoma in the printing industry.

In an occupational mortality surveillance study, cause-specific mortality patterns by occupation and industry, among Rhode Island residents who died during the period 1968-78, were examined using the age-standardized proportionate mortality ratio (PMR) method. A noteworthy finding was an elevated PMR for malignant melanoma among white males in the printing industry (PMR = 460, observed deaths = 6, p less than .01). When the results of other epidemiologic studies are reviewed in aggregate, they are consistent with this finding. A wide variety of chemicals, some of which are known or suspected human or animal carcinogens, are used in the printing industry. There is also potential exposure to ultraviolet radiation. The hypothesis of a relationship between malignant melanoma and occupational exposures in the printing industry should be investigated further.

Adult↗