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Biomedical subjects

V Beral

Publications and source records attributed to V Beral.

At least 109 records · Page 6Linked to original sources
PubMed1992

Spontaneous abortion and work with visual display units.

OBJECTIVE: To determine whether women who work with visual display units are at increased risk of spontaneous abortion. DESIGN: Case-control study. SETTING: Women were recruited during the three years 1987-9 from the Royal Berkshire Hospital in Reading, and from a large group practice situated within the hospital's catchment area. SUBJECTS: Cases were 150 nulliparous working women with a clinically diagnosed spontaneous abortion and controls were 297 nulliparous working women attending for antenatal care. MAIN OUTCOME MEASURES: Cases and controls were contacted and personally interviewed using the same structured questionnaire. Exposure to visual display units (VDUs) at work was assessed from information supplied at interview. RESULTS: No evidence of an increased risk of spontaneous abortion was found in women who reported that they used a VDU at work compared with women who reported that they did not (odds ratio (OR) = 0.9, 95% confidence interval (95% CI) = 0.6-1.4); and no relation with the amount of time spent actively using a VDU was evident (OR = 0.9, 95% CI = 0.5-1.6 for women who worked with a VDU for 21 hours or more each week). No effect of passive exposure to VDUs at work was found (OR = 0.9, 95% CI = 0.6-1.6 for women who reported working less than 10 feet away from a VDU that was usually switched on). These findings were not explained by maternal age, marital state, housing tenure, partner's social class, educational level, smoking, alcohol consumption, or number of previous spontaneous abortions. CONCLUSION: Given the findings and their consistency with the results from other recent studies it is concluded that pregnant women who work with VDUs are not at increased risk of clinically diagnosed spontaneous abortion. For the many women who use VDUs in their jobs, this finding provides reassurance.

Abortion, Spontaneous↗
PubMed1992

Screening for cervical cancer: is there a place for incorporating tests for the human papillomavirus?

Well organized screening programmes for cervical cancer, based on exfoliative cervical cytology, are known to be effective at reducing the incidence of invasive cervical cancer and mortality from the disease. HPV testing should not replace cervical cytology as the first-line approach in screening for cervical cancer, as HPV testing is not sufficiently reliable and some cancers are not associated with HPV infection. Even though there are many unanswered questions about the validity of HPV tests, it is timely to consider whether HPV testing might improve the management of the substantial number of women whose smears are neither clearly normal nor abnormal, but are described as atypical, suspicious or mildly dyskaryotic. The efficacy and costs of incorporating HPV testing into a cervical cancer screening programme need to be evaluated in controlled trials.

Female↗
PubMed1992

Sex hormones and cancer.

There are few instances in which a clear effect of hormones on cancer risk is known and in which the effects of those hormones on the cells concerned are also known. The best examples are the relationships between sex hormones and cancer in women. The effects of sex hormones both on the risk for endometrial cancer and on the cells of the endometrium are well understood, and the evidence strongly suggests that hormones act by altering the rate of cell division. The same mechanism may explain the relationships between sex hormones and the risk for breast cancer, but our understanding of cancers at this site is incomplete. Less still is known about the mechanisms of the effects of sex hormones on other hormone-related cancers, such as those of the ovary and cervix. Most sex hormones are not genotoxic.

Carcinogens↗
PubMed1991

Pooled analysis of 3 European case-control studies: I. Reproductive factors and risk of epithelial ovarian cancer.

The role of reproductive factors in the aetiology of epithelial ovarian cancer has been re-assessed in a meta-analysis of 3 hospital-based case-control studies conducted in Europe (i.e. Italy, the United Kingdom and Greece), providing a total dataset of 1,140 cases and 2,724 controls. Multiple logistic regression models were used to obtain relative risk (RR) estimates adjusted for study centre, age, socio-cultural indicators, age at menopause, and oral contraceptive use. The risk decreased with increasing number of births and the trend in risk was significant (chi 2(1) = 7.50, p less than 0.01). In comparison to nulliparous women, those who reported 4 or more births had a 40% reduction in risk of ovarian cancer (RR = 0.6, 95% confidence interval, CI: 0.4-0.8). An RR estimate of 1.4 (95% CI: 1.1-1.7) as found, overall, for age of 35 or more at first birth compared to age of 25 or less at first birth. In each stratum and overall, nulliparous women did not appear to be at increased risk compared to those who delayed birth of their first child until age 35 or more. In each study, as well as in the overall dataset, an inverse association between number of abortions and ovarian cancer risk emerged. Overall, the inverse relationship was highly significant, RR estimates for 1 and 2 or more abortions, as compared to none, being 0.9 (95% CI: 0.8 and 1.1) and 0.7 (95% CI: 0.6-0.9) respectively. The effects of parity, age at first birth and number of abortions emerged consistently in various strata of study centre and age.

Abortion, Spontaneous↗
PubMed1991

Pooled analysis of 3 European case-control studies of ovarian cancer: II. Age at menarche and at menopause.

The role of age at menarche and at menopause on epithelial ovarian cancer risk was re-assessed in a combined analysis of 3 hospital-based case-control studies conducted in Italy, the United Kingdom and Greece, which produced a total of 1,140 cases and 2,724 controls. In the overall dataset, there was no evidence of an association with age at menarche: compared with women whose menarche occurred at age 15 or over, the relative risk (RR) estimates were 1.0 [95% confidence interval (CI) 0.8 to 1.2] for those with menarche at ages 12 to 14, and 1.0 (95% CI 0.8-1.2) for those with menarche below age 12. There was no consistent interaction between age at menarche and study centre or age at diagnosis. In relation to age at menopause, compared with women whose menopause occurred at age 44 or earlier, the RR was 1.4 between 45 and 49, 1.6 between 50 and 52 and 1.9 above 52. The strength of the association was apparently (but not significantly) greater in the British than in the Greek or Italian dataset. The effect of age at menopause tended to be long-lasting and, if anything, to increase across subsequent age-groups. The large dataset, and the replication of results in different studies, provide more definite and precise information than previously available on the absence of appreciable effect of age at menarche on subsequent ovarian cancer risk in developed countries. For age at menopause, there was a direct and consistent trend in risk, but the association was relatively weak, with RRs below 2 even between extreme categories.

Adult↗
PubMed1991

Pooled analysis of 3 European case-control studies of epithelial ovarian cancer: III. Oral contraceptive use.

The relationship between use of oral contraceptives (OCs) and other contraceptive methods and the risk of ovarian cancer was examined in a combined analysis of 3 hospital-based case-control studies conducted in Italy, the United Kingdom, and Greece, for a total of 971 ovarian cancer cases and 2,258 controls under age 65. Compared with never-users, the combined multivariate relative risk (RR) for ever-users was 0.6 (95% confidence interval, CI = 0.4-0.8) and the estimates were consistent in the 3 datasets. The protection was also similar across strata of age and parity. Considering various measures of OC use, available in the Italian and British datasets only, the protection conveyed on ovarian cancer risk increased with the duration of use and persisted in the medium-long period: the RR in women reporting their last OC use greater than or equal to 15 years prior to diagnosis was 0.5 (95% CI = 0.2-1.0). The risks in ever-users were appreciably lower in those women who reported their first OC use before 25 years of age (RR = 0.3 for first use before age 25, 0.8 for first use at age 25-34 and 0.7 at 35 years or after). Such findings emerged similarly from Italian and British data. This combined analysis, besides offering further quantitative estimates of the protective effects of OCs on ovarian cancer risk in European populations, provides useful insights into the time pattern of the relationship between OC use and ovarian carcinogenesis, suggesting that the protection persists for 15 years or more after cessation of use and may be larger for use at younger age.

Adult↗
PubMed1991

Low birthweight and preterm delivery, Scotland, 1981-84: effect of parents' occupation.

The relation between prematurity and parenteral occupation was examined in a national study of 252,147 liveborn babies delivered in Scotland between 1981 and 1984. Information about mothers' and fathers' work was routinely collected at the first antenatal visit, and birthweight and gestational age were recorded at delivery. Preterm delivery (less than 37 weeks' gestation) and low birthweight (less than 2500 g) were more frequent in the children of mothers and of fathers employed in manual rather than in non-manual jobs. The risk of preterm delivery and/or low birthweight was more than 50% higher in the children of women who worked with electrical, metal, or leather goods than in the children of other female manual workers. These findings were not explained by maternal age, gravidity, marital status, previous perinatal death, baby's sex, or father's social class. For male manual workers, only the children of ceramic workers had an increased risk of prematurity. The risk of a baby being small-for-gestational age (less than or equal to 5th gestation-specific birthweight percentile) varied little with mother's or father's occupation. Overall, the results suggest that parental occupational exposures do not have a pronounced effect on the risk of prematurity, and when there are adverse effects they are associated with maternal rather than paternal exposures.

Female↗
PubMed1991

AIDS-associated non-Hodgkin lymphoma.

Non-Hodgkin lymphoma is associated with HIV infection. We investigated the epidemiology and aetiology of AIDS-related non-Hodgkin lymphoma by analysing data from cases reported to the Centers for Disease Control, Atlanta, USA, up to June 30, 1989. During this period 97,258 AIDS cases were reported, of whom 2824 (2.9%) had non-Hodgkin lymphoma. The condition was about 60 times more common in AIDS patients than in the general US population. 1686 cases were immunoblastic lymphoma, 548 primary lymphoma of the brain, and 590 Burkitt's lymphoma, a condition which is not normally associated with immunosuppression. The proportion of AIDS patients with immunoblastic lymphoma increased from 0% in those under 1 year old to 3.5% in those aged 50 or more. Primary lymphoma of the brain was constant at 0.6% for all ages. The frequency of Burkitt's lymphoma increased from zero in infants to a peak at 10-19 years of age (1.8%). Each type of lymphoma was twice as common in whites as in blacks and in men as in women. Lymphoma was most common in patients with haemophilia or clotting disorders and least common in those born in the Caribbean or Africa who had acquired HIV by heterosexual contact. Epidemiological data suggested that whilst infectious agents (eg, Epstein-Barr virus) may be associated with development of non-Hodgkin lymphomas in AIDS patients there was probably no single cause for all the types of lymphoma. Perhaps the most puzzling question is why Burkitt's lymphoma is commonly associated with HIV infection but not with other types of immunosuppression.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Is risk of Kaposi's sarcoma in AIDS patients in Britain increased if sexual partners came from United States or Africa?

OBJECTIVE: To determine whether the risk of Kaposi's sarcoma in patients with AIDS is increased by sexual contact with groups from abroad with a high incidence of Kaposi's sarcoma. DESIGN: Analysis of risk of Kaposi's sarcoma in patients with AIDS, according to country of origin of their sexual partners. SETTING: United Kingdom. PATIENTS: 2830 patients with AIDS reported to the Communicable Disease Surveillance Centre and the Communicable Disease (Scotland) Unit up to March 1990, of whom 566 had Kaposi's sarcoma. MAIN OUTCOME MEASURES: Percentage of patients with AIDS who had Kaposi's sarcoma. RESULTS: 537 of 2291 homosexual or bisexual men (23%) with AIDS had Kaposi's sarcoma; 10% (14/135) of the men and women who acquired HIV by heterosexual contact had Kaposi's sarcoma. None of the 316 subjects who acquired HIV through non-sexual routes had Kaposi's sarcoma. Kaposi's sarcoma was more common among homosexual men whose likely source of infection included the United States (171/551, 31%) or Africa (9/34, 26%) than among those infected in the United Kingdom (119/625, 19%) (p less than 0.05). CONCLUSION: The data suggest that Kaposi's sarcoma is caused by a sexually transmissible agent which was introduced into the British homosexual population mainly from the United States [corrected].

Acquired Immunodeficiency Syndrome↗
PubMed1991

Congenital malformations in twins in England and Wales.

STUDY OBJECTIVE: The aim was to compare congenital malformation rates in twin births with those in singleton births. DESIGN: The study was an analysis of malformation rates in singleton and twin births using data from the Office of Population Censuses and Survey's Congenital Malformation Notification Scheme. SETTING: This was a national survey of births in England and Wales in 1979-1980 and 1982-1985. PARTICIPANTS: The data comprised 95,510 reported malformations in 3.7 million singleton births, and 1925 reported malformations in 76,000 twin births. MEASUREMENTS AND MAIN RESULTS: Twin malformation ratios were calculated using maternal age specific singleton rates as standard. In comparison with singleton births, twins have significantly higher reported frequencies of indeterminate sex and pseudohermaphroditism; anencephaly; patent ductus arteriosis; exomphalos; hydrocephalus; anomalies of the umbilical vessels; atresia or stenosis of the large intestine or anus; and tracheo-oesophageal fistula, atresia or stenosis. Twins also have significant reported deficits of polydactyly and syndactyly; congenital dislocation of the hip; anomalies of the tongue, branchial cleft and auricular sinus; post-anal dimple; and Down's syndrome. CONCLUSIONS: Several major malformations were significantly more common in twins than in singletons. The excess of indeterminate sex and pseudohermaphroditism has not been described before and may be analogous to freemartinism in cattle. Most of the conditions less common in twins are minor, and the reported deficits may be due to underascertainment of the less serious conditions in twins. Down's syndrome is an exception, and the deficit may well be real.

Congenital Abnormalities↗
PubMed1991

Pernicious anaemia in the textile industry.

The objective was to examine whether the observed excess mortality from anaemia in textile and clothing workers was associated with any specific anaemia type or occupational activity. The design was a death certificate based case-control study of textile and clothing workers who died in England and Wales in the years surrounding the decennial censuses of 1961, 1971, and 1981. The main outcome measures were type of anaemia, place of residence, place of birth, and occupation. The frequency of the different types of anaemia in textile and clothing workers differed from that of England and Wales with relatively more deaths from pernicious anaemia than in the country as a whole (74 observed v 55 expected deaths). Within the industry, those whose death was attributed to pernicious anaemia were more than twice as likely as other textile and clothing workers to have worked in textile mills (odds ratio = 2.4, 95% confidence interval 1.4-4.2). These results could not be explained by age, sex, place of residence, or place of birth, and review of the death certificates did not suggest that pernicious anaemia as a cause of death had been recorded in error. Historical support for the finding was found in the Registrar General's 1931 decennial supplement on occupational mortality, in which the standardised mortality ratio from pernicious anaemia in male textile mill workers was estimated to be twice that of the general population. In conclusion, occupational factors, specifically work in textile mills, could be implicated in the pathogenesis of pernicious anaemia. The aetiology of this disease is not well understood and further study of pernicious anaemia in textile mill workers is required.

Adolescent↗