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Biomedical subjects

Arthur M Michalek

Publications and source records attributed to Arthur M Michalek.

14 recordsLinked to original sources

Patterns of childhood mortality in a region of Belarus, 1980-2000.

UNLABELLED: The public health infrastructure of the former Soviet Union was impacted by both the Chernobyl disaster in 1986 and the Soviet breakup in 1991. This paper examines mortality patterns among children aged 1-14 years within the Mogilev region of Belarus between 1980 and 2000. This study utilized a regional cohort design that included all childhood deaths (ages 1-14 years) occurring among persons residing within the Mogilev oblast of Belarus between 1980 and 2000. Patterns of death and death rates were examined across three intervals: 1980-1985 (pre-Chernobyl), 1986-1991 (post-Chernobyl and pre-Former Soviet Union (FSU) breakup) and 1992-2000 (post-Chernobyl and post-FSU breakup) based upon administrative death files. Annual death rates among children aged 1-4 years declined between 1980 and 2000, while mortality rates among children aged 5-9 years and 10-14 years remained steady over this time period. Average annual mortality rates among males aged 5-9 years and 10-14 years increased significantly between 1986 and 1991. Compared to the baseline interval, mortality among both males and females aged 1-4 years was significantly decreased during 1986-1990 and 1992-2000. In general, mortality rates among males were 24%-95% greater compared to females. Injuries and poisonings accounted for the largest proportion of deaths across all age and gender groups examined. Subsequent to the Chernobyl disaster, significant decreases were noted in mortality rates among children aged 1-4 years while mortality rates among children aged 5-9 and 10-14 remained stable. CONCLUSION: Similar to the findings in other countries, injuries and poisonings predominated as the leading cause of death among Belarussian children.

Adolescent↗

American Indian cancer survivors: exploring social network topology and perceived social supports.

BACKGROUND: The literature on social networks and social supports attests to the powerful influence of social relationships on health; there is a dearth of such studies with American Indians/Alaska Natives. METHOD: This exploratory study assesses the social network topology and perceived social supports received among American Indian cancer survivors and matched controls. RESULTS: Although there did not appear to be marked differences overall among cases and controls, expressive social supports (eg, companionship, moral support, encouragement, advice, and friendship) were ranked highly across each component of the network. CONCLUSIONS: The family appears to be the principal source of social supports relative to either best/closest friend or church/community.

Aged↗

Mentorship.

Explore the source record for details and available documents.

Humans↗

Thyroid cancer incidence trends in Belarus: examining the impact of Chernobyl.

BACKGROUND: While prior studies of thyroid cancer incidence within Belarus have increased since the 1986 Chernobyl reactor accident, the magnitude of increase is not well quantified. METHODS: Using Belarussian national cancer registry data, trends in average annual age-adjusted thyroid cancer incidence rates were examined by calendar year and gender. Incidence rates were also examined across specified time intervals, for specific age groups at diagnosis, and in 'higher exposure' regions compared with 'lower exposure' areas. RESULTS: Age-adjusted thyroid cancer incidence rates (adjusted to the WHO 2000 world population) have increased between 1970 and 2001 from 0.4 per 100 000 to 3.5 per 100 000 among males (+775%) and from 0.8 per 100 000 to 16.2 per 100 000 among females (+1925%). The relative increase among males (+1020%) and females (+3286%) in 'high exposure' areas exceeded increases among males (+571%) and females (+250%) in 'lower exposure' areas of Belarus. Dramatic increases in thyroid cancer incidence rate ratios were noted among both males and females and in all age groups. The highest incidence rate ratios were observed among people from 'higher exposure' areas ages 0-14 yr at time of diagnosis. CONCLUSIONS: Marked increases in the incidence of thyroid cancer have occurred over a relatively limited period of observation in all areas of the Republic of Belarus and among all age categories. The greatest increases have occurred among children, suggesting that a high prevalence of pre-existing iodine deficiency in combination with unique susceptibility among younger people might have contributed to potential carcinogenic exposures to the thyroid.

Adolescent↗

Infant mortality trends in a region of Belarus, 1980-2000.

BACKGROUND: The Chernobyl disaster in 1986 and the breakup of the former Soviet Union (FSU) in 1991 challenged the public health infrastructure in the former Soviet republic of Belarus. Because infant mortality is regarded as a sensitive measure of the overall health of a population, patterns of neonatal and postneonatal deaths were examined within the Mogilev region of Belarus between 1980 and 2000. METHODS: Employing administrative death files, this study utilized a regional cohort design that included all infant deaths occurring among persons residing within the Mogilev oblast of Belarus between 1980 and 2000. Patterns of death and death rates were examined across 3 intervals: 1980-1985 (pre-Chernobyl), 1986-1991 (post-Chernobyl & pre-FSU breakup), and 1992-2000 (post-Chernobyl & post-FSU breakup). RESULTS: Annual infant mortality rates declined during the 1980s, increased during the early 1990s, and have remained stable thereafter. While infant mortality rates in Mogilev have decreased since the period 1980-1985 among both males and females, this decrement appears due to decreases in postneonatal mortality. Rates of postneonatal mortality in Mogilev have decreased since the period 1980-1985 among both males and females. Analyses of trends for infant mortality and neonatal mortality demonstrated continuous decreases between 1990, followed by a bell-shaped excess in the 1990's. Compared to rates of infant mortality for other countries, rates in the Mogilev region are generally higher than rates for the United States, but lower than rates in Russia. During the 1990s, rates for both neonatal and postneonatal mortality in Mogilev were two times the comparable rates for East and West Germany. CONCLUSIONS: While neonatal mortality rates in Mogilev have remained stable, rates for postneonatal mortality have decreased among both males and females during the period examined. Infant mortality rates in the Mogilev region of Belarus remain elevated compared to rates for other western countries, but lower than rates in Russia. The public health infrastructure might attempt to assure that prenatal, maternal, and postnatal care is maximized.

Cause of Death↗

Cancer research training for high school and college students at a comprehensive cancer center.

BACKGROUND: The number of American students pursuing advanced science degree continues to wane. Summer research experience programs are ideal mechanisms to introduce high school and college students to scientific lifestyles. METHODS: A follow-up of participants from 1995-2003 was conducted to gauge student perception of the program and to measure outcomes. RESULTS: Data are presented from the responses of 287 (81%) participants. The Program was successful in recruiting female (67%) and underrepresented (>35%) students. Very high percentages of trainees reported pursuing advanced scientific study (>85% of high school and >92% college students). CONCLUSIONS: Summer research experiential programs can be successful in initiating or maintaining a student's interest in science careers.

Career Choice↗

Influence of various factors on individual radiation exposure from the Chernobyl disaster.

BACKGROUND: The explosion at the Chernobyl Nuclear Power Plant was one of the greatest known nuclear disasters of the 20th century. To reduce individual exposure to ionizing radiation the Soviet Union government introduced a number of counter-measures. This article presents a description of how historical events conspired to disrupt these efforts and affect residents in exposed areas. METHODS: This study employed an extensive review of data on radionuclide deposition, contamination patterns and lifestyle characteristics. Data were obtained from the Ukraine Ministry of Health and the Ukraine Research Center for Radiation Medicine. RESULTS: Data are presented on annual contamination rates in selected locales as well as data on local food consumption patterns. Historical factors including economic and political circumstances are also highlighted. Results show the diminution of individual doses between 1987 and 1991 and then an increase between 1991 and 1994 and the relationship between this increase and changes in the lifestyle of the local population. CONCLUSION: A number of factors played direct and indirect roles in contributing to the populace's cumulative radiation exposure. Future post-contamination studies need to consider these factors when estimating individual exposures.

Disasters↗

Chernobyl-related ionising radiation exposure and cancer risk: an epidemiological review.

The Chernobyl nuclear accident on 26th April, 1986, led to a massive release of radionuclides into the environment. Although vast areas of Europe were affected by Chernobyl-related ionising radiation, the accident had the greatest impact in Belarus, Ukraine, and the Russian Federation. Epidemiological studies that have investigated the link between the Chernobyl accident and cancer have largely focused on malignant diseases in children, specifically thyroid cancer and leukaemia. There is good evidence to suggest that rates of thyroid cancer in children from the countries that were formally part of the Soviet Union have risen as a consequence of the Chernobyl accident. The findings for childhood leukaemia are less conclusive. Overall rates for this disease do not seem to have been affected by the Chernobyl-related ionising radiation, but there may be a larger risk of infant leukaemia in contaminated areas of Europe. Among adult populations, there is no strong evidence to suggest that risk of thyroid cancer, leukaemia, or other malignant disease has increased as a result of the Chernobyl accident.

Adult↗

Efficacy of high-efficiency particulate air filtration in preventing aspergillosis in immunocompromised patients with hematologic malignancies.

OBJECTIVES: To describe and investigate the cause of an outbreak of 10 cases of nosocomial invasive infection with Aspergillus flavus in a hematologic oncology patient care unit. DESIGN: A retrospective cohort study. SETTING: The hematologic oncology unit of a comprehensive cancer center. PATIENTS: Ninety-one patients admitted to the hematologic oncology service between January 1 and December 31, 1992, for 4 or more consecutive days were included in the study. RESULTS: Ten (18%) of 55 patients admitted from July to December 1992 were diagnosed as having invasive aspergillosis compared with 0 (0%) of 36 patients admitted from January to June 1992 to the same patient care units. Patient characteristics, mortality rate, autopsy rate, and admitting location did not change significantly during the course of the year to result in a sudden increase in the number of aspergillosis cases. The source of the outbreak was the high counts of Aspergillus conidia determined from air sampling in the non-bone marrow transplant wing during the outbreak. After high-efficiency particulate air (HEPA) filters were installed as an infection control measure, there were only two additional cases of nosocomial aspergillosis in the 2 years following the outbreak. CONCLUSIONS: This outbreak occurred among hematologic oncology patients with prolonged granulocytopenia housed in an environment with neither HEPA filters nor laminar air flow units. Our data demonstrate that in the setting of an outbreak of aspergillosis, HEPA filters are protective for highly immunocompromised patients with hematologic malignancies and are effective at controlling outbreaks due to air contamination with Aspergillus conidia.

Adolescent↗

Colorectal cancer screening among individuals with and without a family history.

Data from a community-based screening campaign were analyzed to assess compliance with colorectal cancer (CRC) screening guidelines among both average risk adults and those at increased risk because of having a first-degree relative (FDR) with CRC (FDR+). The prevalence of screening compliance was low in both groups. The authors also found that individuals with FDR+ returned a free fecal occult blood test at a slightly higher rate than those without FDR+s. Despite higher screening rates among individuals with FDR+s, interventions may need to target this high-risk group to increase compliance with CRC screening recommendations.

Aged↗

Variation of the prognostic significance of HER-2 expression in breast cancer according to tumor size.

The prognostic importance of HER-2 status in breast cancer has been investigated extensively, but findings have not been uniform across immunohistochemical studies using fixed, paraffin-embedded specimens. We speculate that studies with an overrepresentation of large tumors might not produce evidence for an independent effect of a single marker because breast tumors of larger size tend to exhibit multiple adverse attributes as the malignancy advances through the metastatic cascade. Further, it has been posited that results from certain studies of biologic markers might be generalizable only to larger tumors because tumor repositories tend to house a disproportionate number of larger tumors. To test our hypothesis that the prognostic effect of HER-2 status might be modified by the size of the tumor, we conducted a survival analysis of a nested case-case sample of 156 women diagnosed with primary breast cancer from 1983 to 1995. Relative risks (RRs) and confidence intervals (CIs) for recurrence in relation to HER-2 status were estimated using a multivariate Cox proportional hazards model. Immunohistochemistry of archival tissue was used to detect HER-2 expression. Positive HER-2 status was associated with recurrence (RR = 4.24, 95% CI 1.30-13.78) among patients with axillary lymph node-positive involvement. This analysis identified an interaction (p < 0.01) between tumor size and overexpression. Stratification by tumor size revealed an increased risk of recurrence associated with HER-2-positive tumors that were <or=2 cm in size (RR = 13.68, 95% CI 1.06-175.76), whereas no such association was observed among patients with HER-2-positive tumors larger than 2 cm. Eligible patients without available tumor tissue tended to have smaller tumors compared to study participants. Our results might partly explain the variation in evidence across HER-2 prognostic studies using fixed tissue and might apply to other putative markers of prognosis in breast cancer.

Adult↗