Search PubMed⌕ Search

Biomedical subjects

S Shapiro

Publications and source records attributed to S Shapiro.

At least 19 recordsLinked to original sources
PubMed1992

A case-control study of the risk of breast cancer in relation to oral contraceptive use.

The relation of oral contraceptive use to the risk of breast cancer was evaluated in a case-control study of women under the age of 70 years, conducted in Toronto, Canada, from 1982 through 1986. A total of 607 breast cancer cases identified in a cancer hospital were compared with 1,214 controls matched to the cases on neighborhood and decade of age. Information on oral contraceptive use and risk factors for breast cancer was collected in home interviews. Conditional logistic regression was used to control multiple confounding factors. For women aged 40-69 years (527 cases, 1,054 controls), the results suggest that oral contraceptive use does not increase the risk of breast cancer. Multivariate relative risk estimates were close to or below 1.0 for long durations of use overall and in various categories of parity status and other factors. For women under the age of 40 years, the data were sparse (80 cases, 160 controls). Although there were some elevated relative risk estimates, most were not statistically significant, and there were no consistent patterns across duration of use. The present data add to the body of evidence that indicates that oral contraceptive use does not adversely affect the risk of breast cancer in older women; the data are inadequate to clarify the effect in younger women.

Adult↗
PubMed1992

Breast cancer.

Explore the source record for details and available documents.

Breast Neoplasms↗
PubMed1992

Goals of screening.

BACKGROUND: Colorectal cancer is a major target of inquiry into the effectiveness of screening in the control of the disease by earlier detection and possibly reduced incidence after removal of polyps. Four randomized clinical trials are in process to determine the efficacy of fecal occult blood tests (FOBT) in reducing mortality from colorectal cancer. METHODS: General issues that affect decisions to initiate screening, benefits and risks, and precision of screening are discussed. Trends in incidence, mortality, stage at detection, and survival are reviewed. RESULTS: Colorectal cancer retains a relatively high incidence and mortality; improvements are occurring in stage of detection and survival. Definitive results from randomized clinical trials on efficacy of screening with FOBT are not yet available. CONCLUSIONS: Guidelines for colorectal screening of asymptomatic subjects in the general population have been adopted by the American Cancer Society and the National Cancer Institute. Other organizations have concluded there is insufficient evidence to recommend for or against FOBT.

Aged↗
PubMed1992

Reproductive factors and risk of myocardial infarction.

The relation of reproductive factors to risk of myocardial infarction in women aged 45-69 years was examined in a case-control interview study carried out in Massachusetts from 1986 to 1990. Each of 858 cases of first myocardial infarction was age-matched with a control from the same precinct of residence. Conditional logistic regression was used to control the matching factors and the major known and suspected risk factors for coronary heart disease. For parous women compared with nulliparous women, the estimated relative risk of myocardial infarction was 1.8 (95% confidence interval (CI) 1.0-3.3). Among parous women, the relative risk estimate for five or more births relative to fewer births was 1.4 (95% CI 1.0-2.0); the estimate for a first birth before age 20 relative to a later age at first birth was 1.7 (95% CI 1.1-2.6). The greatest increase in risk was observed for women who had both an early age at first birth and five or more children. However, confounding by factors related to socioeconomic status may have contributed to the results. Compared with women who had a natural menopause at age 50 or older, women who reached the menopause before age 45 were at increased risk regardless of type of menopause: The estimated relative risks were 2.1 (95% CI 1.3-3.2), 1.7 (95% CI 1.0-2.7), and 1.7 (95% CI 1.0-2.8) for early natural menopause, bilateral oophorectomy, and hysterectomy with retention of one or both ovaries, respectively. These results suggest that early cessation of ovulatory function, whether due to natural causes or to surgery, increases the risk of myocardial infarction. Age at menarche was not related to myocardial infarction risk.

Aged↗
PubMed1992

Periodic breast cancer screening in seven foreign countries.

Highly structured breast cancer screening programs with mammography are being introduced in seven foreign countries as a health-care entitlement. Routine screening starts either at 40 years of age or 50 years of age and is usually biennial. In the US, costs (except for Medicare and special programs) and how screening is conducted are dealt with in the private sector; guidelines specify mammography screening at shorter intervals starting at 40 to 49 years of age and include annual clinical breast examination. Provisions of screening programs have been influenced by results of efficacy studies and often by resource considerations. These results show a consistent picture of benefits of screening at 50 years of age and older; the international evidence for younger women is less clear.

Australia↗
PubMed1992

Demographic, reproductive, medical, and environmental factors in relation to gastroschisis.

To identify risk factors for gastroschisis other than drug use in pregnancy, an analysis of data collected in a case-control surveillance program of birth defects (1976-1990) was conducted. Drug use is considered in Werler et al., Teratology, 45:361-367, 1992. Maternal demographic, reproductive, and medical factors, and first trimester environmental exposures, were compared between 76 gastroschisis cases and 2,581 malformed controls. A strong inverse association was found for maternal age: relative to women 30 years or older, relative risks for 25-29, 20-24, and less than 20-year-old women were 1.7, 5.4, and 16, respectively. Multivariate relative risks (and 95% confidence intervals) for alcohol use were as follows: for 1-5 drinks per week, 1.6 (0.7-3.4); for greater than or equal to 6 drinks per week, 2.5 (0.9-6.8); for a maximum of 1-4 drinks at any one time, 0.8 (0.4-1.6); and for a maximum of greater than or equal to 5 drinks, 2.8 (1.2-6.5). With the effect of age taken into account, no associations were identified for cigarette smoking, consumption of caffeinated or decaffeinated coffee, unplanned pregnancy, 12 or less years of education, or a parity of two or more. Other medical and reproductive factors, including weight gain, vaginal bleeding, nausea or vomiting, influenza, "other" infection, and history of spontaneous abortion or elective abortion did not increase the risk.

Abdominal Muscles↗
PubMed1992

First trimester maternal medication use in relation to gastroschisis.

In a case-control surveillance program, first trimester medication use was studied in relation to gastroschisis. There were 76 cases of gastroschisis which were compared with 2,142 controls with other major malformations. For pseudoephedrine use, we found a significantly elevated relative risk of 3.2 (95% confidence interval, 1.3-7.7), with adjustment for confounding. Multivariate relative risks for analgesic/antipyretics and another decongestant were as follows: salicylates, 1.6 (0.9-2.7); acetaminophen, 1.7 (1.0-2.9); ibuprofen, 1.3 (0.4-3.7); and phenylpropanolamine, 1.5 (0.4-5.4). No increases in risk were identified for use of antihistamines, antibiotics, oral contraceptives, or spermicides. Because salicylates, pseudoephedrine, and phenylpropanolamine are vasoactive, the elevated risks for these drugs support the hypothesis of vascular disruption in the etiology of gastroschisis. We therefore examined maternal use of vasoactive medications in relation to a second case group of 416 infants with hetereogeneous defects suspected to have a vascular etiology. Relative risks for salicylates, ibuprofen, pseudoephedrine, phenylpropanolamine, and other decongestants approximated unity. These positive associations must be considered tentative. They have not been reported previously and should be confirmed independently. Also, acetaminophen, which may be taken for the same indications as salicylates and decongestants, but is not thought to be vasoactive, was associated with gastroschisis, suggesting that identified associations may be due to an underlying maternal illness.

Abdominal Muscles↗
PubMed1992

Oral contraceptive use and risk of cutaneous malignant melanoma.

The relation between cutaneous malignant melanoma (MM) and the use of oral contraceptives (OC) was investigated in a case-control study carried out from 1979 to 1991 among patients in hospitals and clinics in the Philadelphia (PA) and New York City (NY) metropolitan areas (United States). Cases were 615 women under age 70 who recently had been diagnosed with invasive melanoma; controls were 2,107 women of the same ages who had been treated for other conditions unrelated either to OC use or to skin diseases. The cases were categorized as severe or nonsevere based on the depth of invasion of the tumor or the presence or absence of metastases. Among the severe cases, OC use was not associated with MM: the relative risk (RR) estimate for ever-use was 1.1 (95 percent confidence interval [CI] = 0.8-1.5) and the estimate for 10 or more years of use was 1.1 (CI = 0.6-2.1). Nor was risk associated with recent use, long latency, or young age at first use. Among the nonsevere cases, ever-use of oral contraceptives was associated positively with MM (RR = 1.5, CI = 1.1-2.4) but there was no trend with increased duration of use. The findings provide evidence against the hypothesis that OC use increases the risk of malignant melanoma. The elevated estimates among the nonsevere cases most likely reflect selection bias rather than a causal relation.

Adolescent↗
PubMed1992

Regional changes in central nervous system thyrotropin-releasing hormone after pentylenetetrazol-induced seizures in dogs.

We have recently shown that seizures induce significant and sustained elevations of thyrotropin-releasing hormone (TRH) in specific extrahypothalamic rat brain regions associated with epileptic foci including amygdala, hippocampus, pyriform cortex, and anterior cortex. Seizures were induced in dogs to further study the effect on central nervous system TRH in a species known to show epileptiform seizures. Adult mongrel beagles were given pentylenetetrazol (PTZ) to induce generalized tonic-clonic seizures. Two groups of dogs were given either PTZ or saline every other day for four intravenous injections. Major motor seizures were observed visually and by electroencephalography with each PTZ injection, and these lasted from 3 to 10 minutes. Forty-eight hours after the fourth seizure, the dogs were killed and brains were removed, dissected, and stored at -90 degrees. After acetic acid extraction, extracts were assayed for TRH content by specific radioimmunoassay. Significant (P < 0.05) postictal TRH increases were seen in frontal cortex (1.5-fold), dorsal hippocampus (2.2-fold), pyriform cortex (2.5-fold), and amygdala (2.1-fold). Cerebellum, medulla, thalamus, hypothalamus, and septum showed no postictal changes in TRH. This report is the first to demonstrate TRH elevations in specific central nervous system regions associated with epileptic foci in the dog. Our results continue to stress the importance of the pyriform/periamygdaloid region as a key limbic region of endogenous TRH action in response to seizures and provides further evidence that TRH is either directly or indirectly involved in seizure modulation. Additional recent data from our laboratory and others suggest that this modulation is intrinsic to the hippocampus and may be anticonvulsant in nature.

Amygdala↗