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S Shapiro

Publications and source records attributed to S Shapiro.

At least 289 records · Page 16Linked to original sources
PubMed1990

Case-control study of idiopathic retinal detachment.

A case-control study of idiopathic, rhegmatogenous retinal detachment (IRD) was conducted to investigate potential risk factors for developing IRD. These included some factors reported previously, such as cardiovascular disease, and some not under suspicion, such as cigarette smoking and iris colour. Cases (n = 198) were incident cases of IRD who were hospitalized for surgical repair of their detachments. Controls (n = 655) were patients hospitalized for conditions unrelated to suspected risk factors for IRD. The risk of IRD appeared to increase with increasing age, and the relative risk for self-reported myopes, compared with non-myopes, was elevated (RR = 3.4, 95% CI = 2.3 - 5.0). The relative risk of IRD was decreased in current smokers (RR = 0.5, 95% CI = 0.3 - 0.8); although there was not a significant trend of decreasing relative risk with increasing amount smoked, the estimate was lowest in those who smoked most heavily. Risk did not appear to be related to gender, eye colour, history of myocardial infarction, or history of hypertension.

Adolescent↗
PubMed1990

A case-control study of alcoholic beverage consumption and breast cancer.

In many studies, moderate alcohol consumption has been associated with increases in the risk of breast cancer of about 50-100%. The authors examined recent alcoholic beverage consumption in relation to the risk of breast cancer in a case-control study of women aged less than 70 years, conducted in Toronto, Ontario, Canada, from 1982 to 1986: 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. The subjects were interviewed at home. Confounding factors were controlled by conditional logistic regression. The relative risk estimates for women who consumed alcohol, relative to women who drank less than one alcoholic beverage (drink) per month, were close to 1.0: for women who drank at least one alcoholic beverage per day, the multivariate estimate was 0.9 (95% confidence interval 0.6-1.2). Among subgroups of women, including those at low baseline risk, there was also no association. For a subset of cases compared with hospital controls, once again there was no association. The relative risk (RR) estimate was elevated for women who drank at least one beer daily (RR = 1.7) and reduced for women who drank at least one glass of wine daily (RR = 0.7), but neither estimate was statistically significant. The results suggest that recent alcohol consumption does not influence the risk of breast cancer. Selection bias cannot be ruled out, however. In addition, because determinants of alcohol use are not well understood, control of confounding may have been incomplete in the present study and in other observational studies of alcohol and breast cancer.

Adult↗
PubMed1990

Reliability of personal interview data in a hospital-based case-control study.

Responses to interview questions were compared for concordance among 492 individuals interviewed more than once in a hospital-based case-control surveillance system in the United States, Canada, and Israel between 1976 and 1982. Reliability of the data was determined using the Kappa statistic and the intraclass correlation coefficient. Reliability was good to excellent for demographic factors, such as birthplace, and for medical conditions/procedures that require hospitalization or continuing medical care, such as hysterectomy. Reliability was fair to good for less serious or less well-defined medical conditions/procedures, such as cystic breast disease, and for current habits, such as daily coffee consumption. Regarding medication use, reliability was poor to fair for drugs taken intermittently, such as aspirin and penicillin, and good to excellent for drugs taken on a regular basis, such as oral contraceptives. As expected, medications were reported more consistently when duration of use was prolonged. The data were also analyzed according to two intervals between interviews (less than 1 year and greater than or equal to 1 year). For most factors, reliability was not materially affected by interval. Where differences were observed, reliability tended to be better when the second interview followed the first by less than 1 year. These results suggest that structured interviews administered to hospital patients by trained personnel can elicit reliable data on demographic and medical history factors.

Adult↗
PubMed1990

Diazepam use in relation to breast cancer: results from two case-control studies.

The relation between diazepam use and breast cancer was explored in two case-control studies. The first (1981-1987) was a hospital-based study in the United States of 3,078 cases of breast cancer, 1,259 controls with other malignancies, and 672 controls with nonmalignant conditions. The relative risk estimates for regular diazepam use (at least 4 days per week for at least 6 months) that antedated the diagnosis of breast cancer by at least 12 months were 1.0 (95% confidence interval (CI) 0.6-1.7) using the cancer controls and 0.8 (95% CI 0.4-1.8) using the noncancer controls. Risk factors for breast cancer were taken into account in the estimates. There was no association for regular use lasting at least 5 years or for regular use that took place exclusively in the recent or more distant past. The second study (1982-1986), conducted in Toronto, Ontario, Canada, was community-based, and included 607 cases of breast cancer and 1,214 neighbor controls selected from municipal voting and census records. After control of confounding, the relative risk estimate for regular diazepam use was 0.8 (95% CI 0.5-1.3). Again, there was no association for long-term, past, or recent regular use. The results of both studies suggest that regular diazepam use does not increase the risk of breast cancer. The findings are strengthened by the similarity of the results using three different control groups--women with cancer, women with nonmalignant conditions, and neighbors.

Adolescent↗
PubMed1990

Oral contraceptive use and the risk of myocardial infarction.

The relation of oral contraceptive use to the risk of myocardial infarction was assessed in a hospital-based case-control study of women aged 25-64 years conducted from 1985 to 1988 in New England; 910 women with first myocardial infarctions were compared with 1,760 control women. Oral contraceptive use, after discontinuation, was not associated with an increased risk of myocardial infarction, whether use had ceased in the distant past or more recently. The overall relative risk estimate for women who had used oral contraceptives in the past for at least 5 years compared with nonusers was 1.1 (95% confidence interval 0.8-1.5) after allowance for confounding factors. Past use was not associated with risk in any age group, in subgroups of women with predisposing factors, or in women at low risk because of the absence of predisposing factors. The results suggest that long-term oral contraceptive use, after discontinuation, does not influence the risk of myocardial infarction. There were few current users and the results for current use were inconclusive: for premenopausal women who had used oral contraceptives in the previous month relative to those who had not, the age-adjusted relative risk estimate was 1.1 (95% confidence interval 0.4-3.1).

Adult↗
PubMed1990

Stature and the risk of myocardial infarction in women.

An inverse association between height and coronary heart disease has been observed in several prospective studies of men, but the reasons for the association have not been established. The relation of stature to the risk of first nonfatal myocardial infarction in women was evaluated in data from a hospital-based case-control study of women under 65 years of age carried out in 1985-1988; 910 cases were compared with 1,140 controls. The risks of myocardial infarction for tall and short women relative to women of average height (63-64 inches (160-163 cm] were estimated, with control for body mass index (weight (kg)/height (m)2), years of education, religion, and the major known risk factors. There was a significant inverse relation of height to myocardial infarction risk (p = 0.003). The relative risk estimate for women greater than or equal to 69 inches (175 cm) tall was 0.5 (95% confidence interval (CI) 0.2-0.8); for women less than or equal to 59 inches (less than or equal to 150 cm) tall, it was 1.5 (95% CI 0.9-2.6). The results were consistent within strata of age, body mass index, educational status, and religion, and they suggest that among women, as among men, those of tall stature have a lower risk of myocardial infarction than shorter individuals. Factors which might explain the association, such as early nutrition, genetic endowment, and artery size, could not be directly evaluated.

Body Composition↗
PubMed1990

Vasectomy and the risk of prostate cancer.

An unexpected association between history of vasectomy and increased risk of prostate cancer emerged when multiple comparisons were carried out in data collected from 1976-1988 in a US hospital-based case-control study of many diseases and exposures. The association was assessed in detail in these data, in a comparison of 220 men with first episodes of prostate cancer with 571 noncancer controls and 960 cancer controls. The age-adjusted relative risk of prostate cancer was 5.3 (95% confidence interval 2.7-10) when noncancer controls were used and 3.5 (95 percent confidence interval 2.1-6.0) when cancer controls were used. The magnitude of the relative risk estimate appeared to be unrelated to the length of the interval after vasectomy. Allowance for several factors did not alter the estimates, but we did not have information on testosterone level or sexual activity, which may have been confounding factors. The association was stronger among men most likely to have been under more intensive medical surveillance; selective detection of asymptomatic cancer in such men would have led to an excess of cases. Further studies are needed to rule out chance, bias from medical surveillance, and uncontrolled confounding as explanations for the finding.

Adult↗
PubMed1990

Quantification of changes in serotonin uptake with spinal cord injury.

The high-affinity uptake of [3H]serotonin was studied using spinal cord preparations obtained from normal dogs, dogs made paraplegic by midthoracic transection, and dogs made monoplegic by midthoracic hemisection. Measurements were made at 1, 4, and 8 weeks after surgery. Lumbar spinal cord was removed at the above time periods and a myelin-free synaptosomal fraction was obtained by centrifugation and used for studying high-affinity serotonin uptake. At 1 week, there were no significant differences for Km values (nM) among any of the three groups (138 +/- 20, 128 +/- 22, and 118 +/- 20). The Vmax values (pmol/min/mg of protein) at 1 week for the control group (4.9 +/- 0.6) versus the hemisected group (4.3 +/- 0.7) were not significantly different. The Vmax values at 1 week for the completely transected group (2.3 +/- 0.3; P less than 0.01) were significantly reduced by 53 +/- 7%. At 4 weeks, the Vmax values for the hemisected (1.8 +/- 0.2; P less than 0.05) and transected groups (0.6 +/- 0.2; P less than 0.05) were significantly different as compared to the control group. The mean percent drop in Vmax after hemisection was 56 +/- 4%, close to the predicted value of 50%. The mean percent drop in Vmax after transection was 86 +/- 2%. At 8 weeks the mean Vmax values for the hemisected (1.9 +/- 0.3; P less than 0.05) and transected (0.4 +/- 0.4; P less than 0.05) groups were not significantly different compared to their respective 4-week values. It appears that serotonin uptake can be used to quantitate roughly the degree of spinal cord injury.

Animals↗
PubMed1990

Common psychological defenses seen in the treatment of sexually abused adolescents.

The negative psychological aftermath of sexual abuse is complex and has a direct correlation with the establishment of maladaptive defense mechanisms. Long-term psychotherapy can allow the adolescent patient to establish the cognitive and affective connections to the original trauma and work through the residue of guilt and shame. As mastery is achieved through the treatment process, higher level defenses should become more pronounced. Because the repressed memories related to the sexual trauma need to be unfolded slowly, so that the defensive capacities are not overwhelmed, treatment may need to be continued into adulthood. This paper proposes a theoretical discussion to assess the psychological defenses commonly seen in adolescents with a history of sexual abuse. Further research is needed on the sexually abused patient's intrapsychic experience and the development of defenses used to ward off painful memories related to the sexual trauma.

Adaptation, Psychological↗
PubMed1990

Cardiac arrhythmias during exercise in severe chronic obstructive pulmonary disease.

We studied the effect of maximal exercise on the prevalence of arrhythmias in 122 subjects with severe COPD. At rest, ten subjects had supraventricular arrhythmias while 13 had unifocal VPB greater than or equal to 6/min or ventricular bigeminy. At peak exercise, six subjects had supraventricular arrhythmias while 24 had VAs. Univariate and multivariate analysis with logistic regression did not show relationships between exercise-related cardiac arrhythmias and the severity of pulmonary disease, oxyhemoglobin desaturation or ECG evidence of chronic lung disease. Exercise-related arrhythmias were significantly associated with the presence of arrhythmias at rest and 87 percent of subjects who had no arrhythmias at rest did not have any during exercise. In patients with COPD, the development of potentially serious arrhythmias during exercise is uncommon without clinically apparent CAD or arrhythmias at rest. However, routine cardiac monitoring during exercise testing should not be abandoned in this population since VAs can occur despite their absence at rest.

Aged↗
PubMed1990

Value of transperineal sonography in the assessment of vaginal atresia.

We studied the value of transperineal sonography in the preoperative assessment of seven patients with clinically suspected vaginal atresia. Although transabdominal scanning is useful to determine if hydrocolpos or hydrometrocolpos is present, this method does not allow measurement of the thickness of a caudally placed obstructive septum. This information is useful in planning reconstructive surgery. All seven patients had transabdominal sonography, with five showing a low-lying obstruction. In those five patients, the distance between the perineal surface and the caudal aspect of the distended vagina, measured with electronic calipers on the transperineal sonograms, ranged from 1.0 to 4.0 cm. We conclude that when vaginal atresia is clinically suspected, transabdominal sonography should be performed to confirm the diagnosis. When a low-lying obstruction is identified, transperineal sonography should be performed to determine the length of the obstructive segment.

Adolescent↗
PubMed1990

The emerging profile of dental manpower in Oklahoma. 1: Oklahoma county.

This is the first report of a three part study. Part I focuses upon the dental manpower profile of Oklahoma County between the years 1972-1989 (Part II will emphasize the dental manpower profile of Tulsa County, and Part III, will be inclusive of the dental manpower profile of all other Oklahoma counties). In all phases of the study, data has been stratified into six categories, namely, general practitioners, specialists, full time general practice dental faculty, full time specialist dental faculty, and public health dentists. The demographic data analyzed in Part I, demonstrated an increasing average age of the dentists from 45.33 years of age in 1972 advancing to 48.33 years of age in 1989. The University of Oklahoma College of Dentistry is currently the primary resource of the dental manpower pool in Oklahoma County. The data indicated a downward turn in the percentage of dentists choosing to locate in Oklahoma County.

Dentistry↗
PubMed1990

Cystic neoplasms of the pancreas.

Cystic neoplasms of the pancreas can be easily misdiagnosed and mistreated by the surgeon unfamiliar with the pathology, natural history, and operative strategy specific to these uncommon tumors. The authors have treated nine patients over a seven-year period involving four cystadenocarcinomas, two mucinous cystadenomas, two serous cystadenomas, and one solid and papillary epithelial tumor. Our experience illustrates the inaccuracies in both clinical and pathologic diagnosis. Suspected cystic neoplasms are optimally managed by resection. Their slow growth and late metastasis permits curative surgery after a previous drainage or bypass procedure. An aggressive surgical approach is therefore warranted, and multimodal treatment with radiation and chemotherapy may be clinically applicable to large, invasive cystadenocarcinomas.

Adult↗
PubMed1990

Hyperbilirubinemia following exposure to pancuronium bromide in newborns.

We investigated the risk of hyperbilirubinemia in relation to the administration of pancuronium bromide among newborn infants requiring mechanical ventilation. One hundred and twenty-nine infants treated with pancuronium were compared to 129 infants who were never exposed, matched on ventilatory status, hospital, birthweight, initial total serum bilirubin, and date of hospital discharge. Overall, the adjusted summary relative risk (RR) for hyperbilirubinemia among pancuronium-exposed infants compared to nonexposed infants was 1.2 (95% confidence interval 1.1-1.4). The risk was greatest among exposed infants during the 4 days following the last dose of pancuronium (RR = 1.4; 1.0-1.8). These data suggest that the use of pancuronium in sick newborns may be associated with an increased risk of clinically important hyperbilirubinemia.

Bilirubin↗