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Biomedical subjects

S Shapiro

Publications and source records attributed to S Shapiro.

At least 307 records · Page 17Linked to original sources
PubMed1989

The relation of aspirin use during the first trimester of pregnancy to congenital cardiac defects.

It has been hypothesized that the ingestion of aspirin by women during pregnancy increases their infants' risk of certain congenital heart defects. Using data from a large program of case-control surveillance of congenital malformations, we evaluated this hypothesis. The case groups were made up of infants with any structural cardiac defect (n = 1381) and five selected cardiac defects (the subgroups were not mutually exclusive): aortic stenosis (n = 43), coarctation of the aorta (n = 123), hypoplastic left ventricle (n = 98), transposition of the great arteries (n = 210), and conotruncal defects (n = 791). First-trimester aspirin use among the mothers of these infants was compared with that among the mothers of a control group of infants with other malformations (n = 6966). The prevalence of any maternal aspirin use was similar for cases (25 to 33 percent) and controls (27 percent). The relative risks (and 95 percent confidence interval) among infants whose mothers were aspirin users as compared with those whose mothers did not use aspirin, adjusted for potential confounding factors, were 0.9 (0.8 to 1.1) for any cardiac defect, 1.2 (0.6 to 2.3) for aortic stenosis, 1.0 (0.6 to 1.4) for coarctation, 0.9 (0.6 to 1.4) for hypoplastic left ventricle, 0.9 (0.6 to 1.2) for transposition of the great arteries, and 1.0 (0.8 to 1.2) for conotruncal defects. Furthermore, no dose-effect pattern was identified. The findings of this study indicate that aspirin use during the first trimester of pregnancy does not increase the risk of congenital heart defects in relation to that of other structural malformations.

Abnormalities, Drug-Induced↗
PubMed1989

"Low yield" cigarettes and the risk of nonfatal myocardial infarction in women.

Newer brands of cigarettes with reduced yields of nicotine and carbon monoxide have been promoted as being less hazardous than others. We evaluated the effect of smoking "low yield" cigarettes on the risk of nonfatal myocardial infarction in women under 65 years of age. The data were obtained in a case-control study of 910 women with a first myocardial infarction and 2375 hospital controls. The estimated relative risk for current smokers as compared with those who had never smoked increased with the number of cigarettes smoked. The estimated overall relative risk was 3.7 (95 percent confidence interval, 3.0 to 4.7). The estimated risks did not vary according to the nicotine or carbon monoxide yield of the cigarette. The estimated relative risk (4.7) in women who smoked brands with the lowest levels of nicotine (less than 0.40 mg per cigarette) was similar to that (4.2) in smokers of the higher-yield brands (greater than 1.30 mg). For exsmokers, the estimated relative risk was 1.4 (95 percent confidence interval, 1.0 to 1.8). These data suggest that women who smoke low-yield cigarettes do not have a lower risk of a first nonfatal myocardial infarction than women who smoke higher-yield brands. For smokers who wish to reduce their risk, switching to low-yield brands is a poor alternative to quitting.

Adult↗
PubMed1989

Measurement of delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine synthetase activity in Streptomyces clavuligerus by high-performance liquid chromatography after precolumn derivatization with o-phthaldialdehyde.

A procedure for rapid, sensitive measurement of delta-(L-alpha-aminoadipyl)-L-cysteinyl-D-valine (ACV) in complex cell extracts has been developed by adapting a widely used method for high-performance liquid chromatography analysis of amino acids. Samples were oxidized with performic acid and derivatized with o-phthaldialdehyde-mercaptoethanol to give the fluorescent isoindole derivative of the peptide sulfonate. The procedure was used to assay Streptomyces clavuligerus cell extracts and partially purified fractions for ACV synthetase activity and to determine some characteristics of the enzyme reaction. The presence of a second enzyme with cysteine as a substrate was also indicated.

Chromatography, High Pressure Liquid↗
PubMed1989

Hydralazine use in relation to cancers of the lung, colon, and rectum.

It has been suggested, based on animal experiments and limited human data, that the anti-hypertensive drug hydralazine might be carcinogenic, and among the sites of concern are the lung and colon. To assess the possible relationship between the use of hydralazine and lung and colorectal cancers in humans, we compared 1006 cases of lung cancer with 3531 hospital control subjects, and 972 cases of colorectal cancer with 3276 controls. Data were collected by interview in hospitals in the United States and Canada. Overall, 1.1% of the lung cancer cases, 1.6% of the colorectal cancer cases, and 1.5% of the controls had used hydralazine. Compared with those who had never used hydralazine, the relative risk estimate of lung cancer for those who first took the drug at least 18 months before hospital admission was 1.1 (95% confidence interval 0.4-2.9). The estimate for use for at least 1 year was 1.4 (0.5-3.8) and for use for at least 5 years the estimate was 0.9 (0.2-4.3). The corresponding relative risk estimates for colorectal cancer were 1.2 (0.5-2.5) for any use, 1.7 (0.8-3.7) for use for at least one year, and 2.4 (0.8-6.9) for five or more years of use. Other antihypertensive treatments and risk factors, including cigarette smoking in the analysis of lung cancer, were taken into account in these estimates. Although the effect of use after long latent intervals could not be evaluated, the results provide no support for the hypothesis that hydralazine use increases the risk of lung cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Comparative study of neuroma formation in the rat sciatic nerve after CO2 laser and scalpel neurectomy in combination with milliwatt CO2 laser "sealing".

Nerve transections of rat sciatic nerves were performed to compare scalpel neurectomy to CO2 laser neurectomy. Additionally, the effect of milliwatt CO2 laser application to the proximal nerve ending was studied. Animals were sacrificed at 1 to 9 weeks, and the neuromas were examined histologically and measured. Scalpel transections produced typical neuromas. Laser transections produced neuromas characterized by multinucleated giant cells and carbonaceous debris. There was no difference in the size of the neuromas produced by either method of transection. Milliwatt CO2 laser application to the proximal stump did not affect the size or histology of resultant neuroma formation regardless of the method of transection.

Animals↗
PubMed1989

Breast cancer before age 45 and oral contraceptive use: new findings.

The relation between the risk of breast cancer before 45 years of age and oral contraceptive use was examined in a case-control study conducted in New York, Philadelphia, Baltimore, and Boston from 1983 to 1986 of 407 patients with breast cancer and 424 controls. With allowance for confounding, for ever use, the multivariate relative risk estimate was 2.0 (95% confidence interval (CI), 1.4-2.9). For less than 10 years of use, the estimate approximated 2.0 in all categories of duration, including less than three months; for 10 or more years of use it was 4.1 (95% CI, 1.8-9.3). The association was apparent in virtually all subgroups examined, including younger and older women, and women at low and high underlying risk of breast cancer. Contrary to some previous reports, the association was not stronger for use before a first term pregnancy or at an early age. The results suggest that oral contraceptive users, particularly those with very long durations of use, may be at increased risk of breast cancer. However, information bias, particularly for short-term use, could not be ruled out. There may also have been selection bias if oral contraceptive users were under more intensive medical surveillance. It has not been possible to reconcile the findings of the various studies to date, including the authors' earlier results showing no association. The latter results were derived from data collected using methods almost identical to those used in the present study.

Adult↗
PubMed1989

Tar content of cigarettes in relation to lung cancer.

Although it is generally considered established that the risk of lung cancer is directly related to the tar content of cigarettes, an examination of the results of previous studies does not yield conclusive evidence in favor of the hypothesis. The authors evaluated this issue in a study of 881 cases of lung cancer and 2,570 hospital controls who were 40 to 69 years of age; data were collected by interview in hospitals in the United States and Canada from November 1981 to June 1986. For each year of smoking, cigarette brands were classified according to their tar content as published in regular Federal Trade Commission reports (from 1967 to 1985) or the Reader's Digest (from 1957 to 1966). Tar values for years for which there was no published information were estimated by interpolation. Smokers were divided, according to the tar content of their cigarette brands averaged over a specified period, into low (less than 22 mg/cigarette), medium (22-28 mg/cigarette), and high (greater than or equal to 29 mg/cigarette) tar smokers. When the average tar content was based on cigarettes smoked at least 10 years previously, the relative risk estimates for medium and high tar smokers compared with low tar smokers were 3.0 and 4.0 after control for potentially confounding factors, including the number of cigarettes smoked per day. The trend was significant (p = 0.002). The tendency for the risk of lung cancer to increase with increasing tar content was consistent among men and women. The results provide further support for the hypothesis that the tar content of cigarettes is directly related to lung cancer risk. However, the data were limited in that there were very few subjects whose lifetime tar exposure averaged less than 10 mg/cigarette.

Adult↗
PubMed1989

Oral contraceptive use and liver cancer.

The risk of liver cancer in relation to use of oral contraceptives was evaluated in a hospital-based case-control study conducted in five US cities from 1977 to 1985. Twelve new cases of liver cancer were identified in women aged 19-54 years; five controls selected from among patients hospitalized for acute conditions unrelated to oral contraceptive use were matched to each case on age (five-year categories), date of interview (three-year categories), and geographic location of the hospital. Among nine cases classified as having hepatocellular carcinoma, eight (89%) had used oral contraceptives; only 16 (36%) of 45 matched controls had used oral contraceptives. Among three other cases (two with cholangiocarcinomas and one with liver cancer of undetermined type), all had used oral contraceptives, compared with four of 15 matched controls. The results confirm the strong positive association between oral contraceptive use and hepatocellular carcinoma observed in earlier studies. Such an association is consistent with evidence that oral contraceptive use is associated with benign hepatic tumors in young women. However, the number of cases of liver cancer in the United States that are attributable to oral contraceptive use is probably small, because liver cancer is extremely rare in the United States.

Adenoma, Bile Duct↗
PubMed1989

The risks of cancers of the colon and rectum in relation to coffee consumption.

To assess whether recent coffee consumption is related to the incidence of large bowel cancer, the authors analyzed data from a multipurpose hospital-based case-control study of several cancers, conducted from 1978 to 1986 in Boston, Massachusetts, New York, New York, Philadelphia, Pennsylvania, and Baltimore, Maryland: 717 cases of colon cancer and 538 cases of rectal cancer were compared with 3,883 controls admitted for nonmalignant and malignant illnesses unrelated to coffee use. Relative risks were estimated by multiple logistic regression with allowance for age, sex, cigarette smoking, alcohol consumption, and several other potential confounding factors. Overall, relative to the consumption of one cup of coffee per day, the estimated relative risk of colon cancer for consumption of up to four cups per day in the period before admission was close to 1.0; for consumption of five or more cups per day, it was 0.6 (95% confidence interval 0.4-0.8). The results were consistent in men and women, and similar results were obtained whether the measure of consumption was use in the year before admission or use three years before admission. For rectal cancer, some relative risk estimates were elevated, particularly in men, but there was no consistent pattern of association, nor was there a trend of increasing risk with increasing consumption. The data suggest that recent coffee consumption is not related to an increased risks of large bowel cancer and that heavy coffee consumption may reduce the risk of colon cancer. A biologic rationale for such a reduction has not been established.

Adult↗
PubMed1989

Noncontraceptive estrogen use and epithelial ovarian cancer.

The relation of noncontraceptive estrogen use to epithelial ovarian cancer was evaluated in a case-control study conducted in hospitals mainly in the northeastern United States. There were 377 cases diagnosed within the year before hospital admission and 2,030 hospital controls; data were collected by interview in the hospital. Compared with women who never took noncontraceptive estrogens, the overall relative risk estimate for women whose estrogen use lasted at least one year and was not combined with progestogens or testosterone was 1.2 (95% confidence interval (CI) 0.8-1.9), after taking into account risk factors for ovarian cancer. There were 55 cases of the endometrioid, clear cell, or malignant mixed mesodermal cell type; the corresponding relative risk estimate was 0.9 (95% CI 0.3-3.0). There were 26 cases of undifferentiated cell type, with a relative risk estimate of 3.6 (95% CI 1.2-11). Relative risk estimates were similar in a subset of the cases (57%) for which pathology slides were reviewed. For estrogen use of long duration, use of high-dose preparations, or use in the distant past, the relative risk estimates were not significantly different from 1.0. The estimates were elevated for some categories of use, but not consistently--for example, for an interval of 5-9 years since estrogen use began (relative risk (RR) = 2.7), but not after shorter or longer intervals, and for use of conjugated estrogens with a dose of 0.3 mg (RR = 3.2) or 1.25 mg (RR = 2.4), but not for doses of 0.625 mg or 2.5 mg. The relative risk estimate was also elevated for use by nulliparous women (RR = 2.4). The results suggest that, overall, noncontraceptive estrogen use is not associated with the risk of epithelial ovarian cancer. Furthermore, our data do not support the hypothesis that estrogens increase the risk of endometrioid ovarian cancer. The elevated estimates could be due to multiple stratification of the data, but they should be explored in further studies, given the lethality of ovarian cancer and the common use of estrogens by postmenopausal women.

Adult↗
PubMed1989

Microvascular end-to-side arterial anastomosis using the Nd: YAG laser.

End-to-side, laser-assisted vascular anastomosis (LAVA) using a Nd: YAG laser was successfully performed on rat carotid arteries. A midline neck incision allowed isolation and approximation of both carotid arteries in an end-to-side fashion using four 10-0 nylon stay sutures. The laser parameters used for vessel fusion were 0.3-second 5-W pulses at a spot size of 600 microns. Anastomoses were analyzed at various time intervals from 1 day to 6 months by angiogram and histological examination. The anastomotic patency was 86%. Aneurysm formation occurred in 23%. Histological examination revealed an acute/subacute transmural injury both at the anastomotic site and several hundred microns away, with delayed re-endothelialization and some attempt at muscular and elastic regeneration. Histological assessment of the aneurysms demonstrated a total loss of the internal elastic lamina and muscularis. A brief discussion comparing Nd: YAG LAVA to other LAVA techniques follows.

Anastomosis, Surgical↗
PubMed1989

The incidence of specific DIS/DSM-III mental disorders: data from the NIMH Epidemiologic Catchment Area Program.

Incidence data are presented for the 7 most frequent specific categories of mental disorder available in the NIMH Epidemiologic Catchment Area (ECA) program (major depressive disorder; panic disorder; phobic disorder; obsessive-compulsive disorder; drug abuse/dependence; alcohol abuse/dependence; cognitive impairment). The DSM-III case definitions in the ECA Program are according to the implementation of the Diagnostic Interview Schedule (DIS). Rates of incidence are presented specific for age, sex, and site, and pooled smoothed curves for the relationship of age to incidence, specific for sex are shown. The 7 disorders have distinctly different relationships to sex and age of onset.

Adolescent↗
PubMed1989

Late anaplastic gliomas in children previously treated for acute lymphoblastic leukemia.

At least 33 cases of late anaplastic gliomas in children previously treated for acute lymphoblastic leukemia have been discussed in the literature including 20 well-documented cases. The frequency of this second malignancy is much greater than expected and may represent a 'new syndrome' with some genetic predisposition. Additionally, CNS prophylaxis which includes both radiation and intrathecal methotrexate appears to work synergistically in increasing the incidence of glial tumors especially multifocal tumors in these patients. The prognosis for these children is dismal but an aggressive treatment approach including surgery, interstitial radiation, and chemotherapy appears to improve survival.

Adolescent↗