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Biomedical subjects

A S Morrison

Publications and source records attributed to A S Morrison.

At least 19 recordsLinked to original sources
PubMed1998

Identifying donor concerns to increase live organ donation.

Increasing organ donation from live donors is a means to increase the pool of kidneys available for transplantation. To increase the number of live kidney donors, the major concerns of donors must be determined and addressed. This article describes the health and socioeconomic concerns of 61 live kidney donors from the Johns Hopkins Institutions between February 1, 1995 and December 1, 1997. Seventy-five percent of donors reported they had concerns, the most common ones being the effect of donation on their future health, how many work days they would miss, the ability to return to the same activities, and the pain they would experience. Other reported concerns consisted of fear of dying, the risks to a future pregnancy with one kidney, the fear that a son or daughter may need a kidney in the future, and the impact of donation on the family health insurance premium. Interventional strategies including the use of the laparoscopic donor nephrectomy procedure are offered to address these concerns.

Absenteeism↗
PubMed1993

The relation of surgery for prostatic hypertrophy to carcinoma of the prostate.

The authors evaluated the risk of death from prostate cancer in Rhode Island men who had had surgery for prostatic hypertrophy during the years 1959-1970. The retrospective follow-up method was used. Among 4,853 men who had had either a transurethral resection or a prostatectomy, age- and time-standardized mortality from prostate cancer was 1.14 (95% confidence interval (CI) 0.93-1.33) times the rate in the general population of Rhode Island men. The age- and time-standardized mortality ratio was 1.01 (95% CI 0.77-1.31) for men who had had a suprapubic prostatectomy and 1.18 (95% CI 0.94-1.47) for men who had had a transurethral resection. The authors used the case-control method to relate the histologic features of prostatic hypertrophy to subsequent prostate cancer. The observed associations were weak and inconsistent. The results of this study suggest that surgically treated prostatic hypertrophy is not an important determinant of prostate cancer.

Age Factors↗
PubMed1992

Relationship of polyps to cancer of the large intestine.

BACKGROUND: Pathologic and epidemiologic evidence indicates that patients with sporadic (nonfamilial) adenomatous polyps of the large intestine are at high risk of developing colorectal cancer. PURPOSE: Our primary goal in this study was to evaluate the colorectal cancer mortality rate among persons who have had a histologically confirmed benign colorectal polyp. METHODS: We used the retrospective follow-up method to evaluate the risk of death from colorectal cancer in 2872 Rhode Island men and women who were 24 through 79 years of age at the time of surgery for benign polyps in the years 1959 through 1975. RESULTS: Among 2872 subjects, the mortality from colorectal cancer, standardized for age, sex, and calendar time, was estimated as 1.74 (95% confidence interval = 1.44-2.09) times the rate in the general population of Rhode Island residents. Colorectal cancer mortality was higher in the first 5 years of follow-up than it was later. There was little relationship between the numbers of polyps and colorectal cancer mortality, and there was only a modest association between the size of polyps and mortality. Colorectal cancer mortality was more than twice as high in subjects whose polyps were proximal to the sigmoid compared with those with sigmoid or rectal polyps. The observed elevation of risk of colorectal cancer was almost entirely confined to subjects who had an adenomatous polyp. The risk increased strongly with the percentage of villous features in the polyp and was about twice as high in subjects with villous adenoma than in those with other adenomatous polyps. CONCLUSIONS: Our results support the suspected relationship between colorectal polyps and cancer incidence and extend the association to colorectal cancer mortality.

Adult↗
PubMed1992

Risk factors for surgery for prostatic hypertrophy.

The purpose of this case-control study was to evaluate potential risk factors for prostatic hypertrophy. The cases were 910 residents of Rhode Island who had a partial or total prostatectomy that was not related to cancer in the years 1985-1987. The controls were 2,003 members of the source population who were selected from a list of holders of Rhode Island driver's licenses or a roster of older Americans compiled by the Health Care Financing Administration. Cases and controls were interviewed by telephone. The risk of prostatic hypertrophy was elevated in Jewish men compared with Protestants and Catholics and in blacks compared with whites. Risk was reduced in ever-married compared with never-married men, in men who had left school at age 16 years or more compared with those who had left earlier, and in relatively tall or relatively heavy men. Coffee drinking and cigarette smoking were inversely but only weakly related to prostatic hypertrophy. There was a relatively strong, although irregular, inverse relation of beer drinking to prostatic hypertrophy. The associations of spirits and wine consumption with prostatic hypertrophy were weak.

Age Factors↗
PubMed1992

Efficacy of screening for breast cancer in older women.

The effect of screening on mortality from breast cancer has been evaluated in four intervention (experimental) studies with random assignment, one intervention study with nonrandom assignment, three case-control studies, and one follow-up study. Each of these studies showed a beneficial effect of screening among women who were at least 45, 50, or 55 years old at entry, but there is almost no information available on the value of screening women more than 74 years old. The data are not helpful in choosing a screening interval within the range 12-33 months, or in deciding whether to screen by mammography and palpation combined or by mammography alone. Additional issues in screening very old women are the delay before the effect of screening appears, the high mortality from causes other than breast cancer, and the effect of previous screening.

Adult↗
PubMed1992

Epidemiology of bladder cancer.

Approximately 49,000 persons in the United States develop bladder cancer each year, and about 9700 die of it. White men face a lifetime risk of almost 3%; white women and black men face a risk of about 1%, and black women, about 0.5%. Cigarette smoking is accepted widely as a cause of bladder cancer. Smoking accounts for about half of bladder cancer diagnosed among men and about one third of that among women. Moderate to heavy smokers typically show a two to five fold risk of bladder cancer, compared with persons who never smoked. When cigarette smokers quit smoking, their bladder cancer risk falls measurably within 2 to 4 years, but probably does not continue to decline with increasing years since quitting and does not appear to return to the baseline level of nonsmokers. Occupational exposure to certain aromatic amines causes human bladder cancer. Clear evidence of bladder cancer risk also is apparent for a small number of occupational groups: dye workers, rubber workers, leather workers, painters, truck drivers, and aluminum workers. Many other occupational groups have been reported to have increased bladder cancer risk, but evidence for these is not as strong. Coffee drinking has been studied extensively as a potential risk factor, but the inconsistency of the observed associations suggests that the relationship is either quite weak, noncausal, or dependent in a complex way on unmeasured factors. Artificial sweeteners confer little or no excess bladder cancer risk. Alcohol consumption apparently does not affect risk either. Consumption of fruits, vegetables, and foods high in vitamin A have been suggested as possible protective factors; consumption of high-fat foods, pork, and beef have been suggested as possible risk factors. Further epidemiologic research is needed to elucidate the role of diet in human bladder carcinogenesis. Less common risk factors for bladder cancer include ionizing radiation, cyclophosphamide use, and abuse of phenacetin-containing analgesics. Schistosomiasis infection may contribute substantially to the bladder cancer burden in Egypt and elsewhere, though not in the United States.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1991

Intermediate determinants of mortality in the evaluation of screening.

The long time needed to carry out experimental studies of screening for chronic diseases limits their usefulness. This paper describes a method of using prognostic factors, such as the stage of cancer, determined at the time of treatment in screened and unscreened groups to predict the subsequent population mortality rate in each group. The method of prediction makes use of available data on the relation of case fatality to the prognostic factors. Such predictions could be made several years in advance of the time that mortality would be observed directly. The method is illustrated by use of data from the Health Insurance Plan (HIP) study of screening for breast cancer. A reduction of mortality in screened compared to unscreened women was predicted, but it was substantially less than the reduction that was observed. Potential sources of error in the predictions are discussed.

Breast Neoplasms↗
PubMed1991

Beta-blocker therapy: identification and management of side effects.

The purpose of this study was to develop and test a new beta-Blocker Visual Analog Scale designed to identify and quantify the impact that the side effects of beta-blocker therapy have on people's lives, and the self-management practices people use to mediate their influence. Instruments included the 20-item beta-Blocker Visual Analog Scale and the Profile of Mood States. Subjects had hypertension; 51 men were involved in a larger study involving antihypertensive medications and exercise, and 19 men and women were receiving beta-blocker therapy as first-line drug of choice. Estimates of internal consistency reliability, content validity, and concurrent and discriminant validity were moderately strong. The most problematic side effects were related to lack of sleep, vivid or active dreams, lack of energy and pep, diminished interest in sexual activity, and changes in vision. Among self-management practices used to mediate side effects were planning rest and activity periods, thinking carefully before reacting, and seeking out others for support.

Adaptation, Psychological↗
PubMed1989

Histologic and mammographic specificity of risk factors for benign breast disease.

This study evaluates the effects of potential risk factors for benign breast disease (BBD) with special attention to the histologic and mammographic specificity of the effects. Cases were 172 women with BBD that underwent biopsy; controls were 134 women free of breast signs or symptoms. All cases and controls had undergone mammography. For all types of BBD combined, parity, use of oral contraceptives, and use of exogenous estrogen after menopause were strongly protective, whereas obesity and early menarche were weakly protective. Family history of breast cancer was virtually unrelated to BBD. The protective effect of parity was stronger for BBD with intralobular or extralobular fibrosis, and with mammographic homogeneous density or large nodular densities, than it was for BBD without these characteristics. Similar relations with the histologic and mammographic features were observed for obesity. These findings suggest that some risk factors for BBD have effects that are related to specific features of its morphology.

Breast Diseases↗
PubMed1989

Diet, mammographic features of breast tissue, and breast cancer risk.

This case-control study was designed to reevaluate the association of the morphology of breast tissue seen on mammograms with breast cancer risk and to assess the relation of diet, especially intake of fat and vitamin A, to the high-risk mammographic images. The cases included 290 patients with newly diagnosed breast cancer who were first treated in Quebec in 1982-1984. The controls included 645 women who participated in the Canadian National Breast Screening Study. Risk of breast cancer was higher among women with the P2 or DY parenchymal pattern (relative risk (RR) = 3.7, 95% confidence interval (Cl) 2.0-7.0) than it was among those with the N1 pattern. Moreover, risk increased regularly with the extent of nodular and homogeneous densities on the mammogram. Relative risk was 5.5 (95% Cl 2.3-13.2) for women in whom 60% or more of the volume of the breast showed either nodular or homogeneous densities compared with women without such densities. Among controls, increase in energy-adjusted saturated fat intake was associated with an increase in extent of high-risk mammographic features. Energy-adjusted polyunsaturated fat or cholesterol intake did not, however, appear to influence the morphology of breast tissue seen on the mammogram. Increasing carotenoid and fiber intakes were associated with a reduction of the extent of densities on the mammogram, but retinol intake seemed to have little or no effect on mammographic features. These data suggest that elevation in saturated fat intake and reduction in carotenoid and fiber intakes may be related to an increase in breast cancer risk through effects of these nutrients on breast tissue morphology.

Adult↗
PubMed1988

Mammographic parenchymal features and breast cancer in the breast cancer detection demonstration project.

The Breast Cancer Detection Demonstration Project (BCDDP) screened 283,222 U.S. women for breast cancer by use of mammography and breast palpation. A sample of participants was followed up to determine the subsequent occurrence of breast cancer cases and deaths. We have used information from the BCDDP to evaluate the relation of mammographic parenchymal features to the incidence of and mortality from breast cancer, and to examine changes in this relation with duration of follow-up. We also reevaluated the relations of age, body weight, height, menopause, parity, and age at birth of first child to mammographic features of breast tissue. Among women 35-49 years of age at entry, those whose mammographic features were "glandular" or "homogeneously dense" had a 2.8-fold increase in risk of breast cancer compared to women whose mammographic features were "atrophic or fatty". The increased risk was observed up to 9 years after entry. Among women 50-74 years of age at entry, the risk of breast cancer was elevated by a factor of 1.7 for women with glandular or dense breast parenchyma compared to those with atrophic or fatty breasts. The increase in risk, however, diminished with increasing follow-up. The percentage of women with glandular or dense parenchymal features decreased as age, body weight, and parity increased. The percentage with glandular or dense features increased as height increased, and the percentage decreased with menopause. Mammographic parenchymal features were not associated with age at birth of first child.

Adult↗
PubMed1988

Breast cancer incidence and mortality in the breast cancer detection demonstration project [published errtum appears in J Natl Cancer Inst 1989 Oct 4;81(19):1513].

The Breast Cancer Detection Demonstration Project (BCDDP) was a program of five annual screening examinations for breast cancer that was conducted at 29 centers in the United States. This report presents data on breast cancer incidence and mortality among the participants. A total of 283,222 women were enrolled. Our analysis is based on 55,053 white women who were 35-74 years of age at entry and who were selected for follow-up. For the first 9 years after entry, the cumulative incidence of breast cancer was estimated as 243.6 per 10,000, which is 1.34 times the expected incidence derived by use of data from the Surveillance, Epidemiology, and End Results (SEER) program. In contrast, 9-year cumulative mortality from breast cancer was only 79.6% of that expected in women with the age distribution of BCDDP participants who did not have diagnosed breast cancer at the start of observation. The ratio of observed to expected breast cancer mortality was 0.89 for women 35-49 years of age at entry, 0.76 for women 50-59 years of age at entry, and 0.74 for women 60-74 years of age at entry. Breast cancer incidence and mortality were lower for women who entered the BCDDP for routine screening than they were for women who entered for a reason such as concern about breast disease, family history of breast cancer, or a physician's recommendation. Among cases diagnosed within 5 years of entry, the 5-year case fatality attributed to breast cancer was 8.5%. Case fatality for all stages combined was greater than 50% lower for cases that were screen-detected than it was for cases that were not screen-detected. Case fatality was lower for cases diagnosed within the first 5 years of entry (which encompassed the period of screening) than it was for cases diagnosed in the sixth or seventh years.

Adult↗
PubMed1988

Relationship between mammographic and histologic features of breast tissue in women with benign biopsies.

Mammograms and histologic slides of a group of 320 women who had breast symptoms and a biopsy without cancer being found were reviewed. The mammographic features assessed were the parenchymal pattern and extent of nodular and homogeneous densities. In addition to the pathologic diagnosis, the histologic features assessed included epithelial hyperplasia and atypia, intralobular fibrosis, and extralobular fibrosis. Among premenopausal women, those with marked intralobular fibrosis were more likely to have large (3+ mm) nodular densities on the mammogram. Among postmenopausal women, epithelial hyperplasia or atypia was related to having nodular densities in at least 40% of the breast volume. In both groups, marked extralobular fibrosis was related to the presence of homogeneous density on the mammogram. We conclude that mammographic nodular densities may be an expression of lobular characteristics, whereas homogeneous density may reflect extralobular connective tissue changes.

Adult↗
PubMed1987

Epidemiology and environmental factors in urologic cancer.

Urologic cancers include malignancies of the genital and the urinary organs of men, and the urinary organs of women. For men in the United States, urologic cancers account for about 25% of all new cases of cancer and about 15% of cancer deaths. For women, cancers of the urinary organs account for 4% of all new cases of cancer and 3% of cancer deaths. Of urologic cancers, bladder cancer has been the most intensively studied epidemiologically. Cigarette smoking is the most important known preventable cause of the disease. Occupational exposures continue to come under suspicion. It appears that neither coffee drinking nor use of artificial sweeteners are important risk factors. Current questions in the etiology of prostate cancer concern its relationships to benign prostatic hypertrophy, to components of the diet and to hormone metabolism. Little is known of the etiology of kidney cancer other than probable associations of the disease with cigarette smoking and exposure to asbestos. Testicular cancer is associated with undescended testis and possibly other urogenital anomalies. The relationships of testicular cancer to pesticide exposure, in utero estrogen exposure, and infection are current research issues.

Environmental Exposure↗
PubMed1987

Case-control study of hepatocellular carcinoma, occupation, and chemical exposures.

The relation of hepatocellular carcinoma (HCC) to occupation and chemical exposures was evaluated in a case-control study. The study included 80 cases and 146 matched hospital controls on whom a work history was obtained. No persuasively positive association between HCC and any particular occupation, industry, or chemical exposure was found. However, the relative rate (RR) of HCC for persons employed in highway construction compared with those never so employed is 5.0 with 95% confidence limits (CL), 1.0 to 26. The RR for farming occupations, 1.4 (95% CL, 0.7 to 2.9), is also slightly elevated. The RR for persons exposed to pesticides compared with those not exposed is 2.4 (95% CL, 0.9 to 6.5). Asphalt exposures are associated with a RR of 3.2 (95% CL, 0.9, 11). These findings are compared to the results of other epidemiologic studies.

Adult↗