PubMed Health⌕ Search

Biomedical subjects

D Trichopoulos

Publications and source records attributed to D Trichopoulos.

At least 73 records · Page 4Linked to original sources
PubMed2001

Risk factors for cholangiocarcinoma in a low risk Caucasian population.

OBJECTIVES: Little is known about the etiology of cholangiocarcinoma, apart from its association with liver fluke infestation. METHODS: A case-control study was conducted in Athens and included six cholangiocarcinoma cases, 333 hepatocellular carcinoma cases and 360 controls with minor ailments or injuries. All subjects were interviewed and tested for hepatitis B and C infection. For all six cholangiocarcinomas, 97 hepatocellular carcinomas and 129 controls, sex steroids were determined in the blood. RESULTS: Hepatitis B or C viruses, tobacco smoking, alcohol drinking and diabetes mellitus were not related to cholangiocarcinoma, but history of thyroid disease was. Estradiol levels were higher among cholangiocarcinoma cases than among the other two groups. CONCLUSIONS: This study provides evidence that endocrine and autoimmune factors are important in the etiology of cholangiocarcinoma.

Adult↗
PubMed2001

Reliability of data on medical conditions, menstrual and reproductive history provided by hospital controls.

To assess the reliability of data on medical conditions, and menstrual or reproductive history, a sample of 294 controls interviewed in hospital between 1989 and 1992 for an Italian case-control study on digestive tract neoplasms was re-interviewed at home during 1993. A high agreement between responses at the two interviews (kappa > or = 0.85) was observed for most medical conditions, including diabetes, cholelithiasis, hepatitis, duodenal ulcer, and, among female conditions, uterine fibromas, benign breast disease, hysterectomy and monolateral ovariectomy. For gastric ulcer and parotitis the reliability was less satisfactory (kappa = 0.35 and 0.20, respectively). The agreement was high (kappa > 0.80) also for age at menarche, menopausal status, type and age at menopause, number of children, age at first pregnancy, age at first and last birth, and spontaneous abortions. The agreement was lower for questions on menstrual pattern (kappa = 0.68) and induced abortions (kappa = 0.62). Thus, this study indicates that information on personal medical conditions, and menstrual or reproductive history, provided by hospital controls through an interviewer-administered questionnaire is satisfactory for the purposes of epidemiological inference, and that the interview setting does not substantially influence the recall of this information.

Adult↗
PubMed2001

Primary and secondary prevention in the reduction of cancer morbidity and mortality.

Overall, cancer is a highly preventable disease. Indeed, modifiable external factors, discovered by epidemiological studies during the last 50 years, account for a majority of all cancer deaths. In this review, we discuss briefly these factors and their contribution to the current burden of cancer with an emphasis on the developed countries. Needless to say, tobacco smoking remains the largest contributor to the cancer landscape, whilst the contribution of poor diet and obesity may be equally important, but much more difficult to quantify. Our main goal was to assess what prevention of cancer has accomplished and might accomplish in the next two decades. Based on (necessarily crude) estimates, age-adjusted mortality rates from cancer in year 2000 had been reduced by approximately 13% due to primary prevention and an additional 6% due to the combined effect of early diagnosis and screening (secondary prevention). According to a realistic goal for the year 2020, a further 29% reduction might be achieved by primary, and 4% by secondary prevention. The main contribution to such accomplishments would be a reduction in tobacco smoking, improvements in diet--including reduced alcohol intake--and arrest of the obesity epidemic, in part through increased physical exercise. Rather than being granted, these goals require great effort and major commitment from all those who share responsibility for public health.

Diet↗
PubMed2001

Breast cancer risk in male alcoholics in Sweden.

OBJECTIVE: To investigate the association between alcoholism and risk of male breast cancer. METHODS: We conducted a retrospective population-based cohort study in Sweden of men diagnosed with alcoholism between 1965 and 1995. The cohort was followed up through interlinkages with nationwide registries (the national cancer registry, immigration registry, causes of death registry, and population registry), using the national registration numbers. Standardized incidence ratios (SIRs), calculated using the Swedish national cancer incidence rate as reference, were used as estimates of relative risks. RESULTS: A total of 145,811 men were enrolled into the cohort, contributing 1,499,504 person-years of follow-up. Sixteen incident breast cancer cases were identified, and the mean age at diagnosis was 68 years. We excluded the first year of follow-up (cases and person-years) from the analysis to avoid detection bias. The overall SIR (excluding the first year of follow-up) was 1.1 (95% CI 0.6-2.0). Although based on small numbers we found no indication of a differential SIR according to duration of follow-up, age at cohort enrolment, or age at follow-up (attained age or age at cancer diagnosis). CONCLUSION: The observed associations are not compatible with an increase in breast cancer risk among male alcoholics.

Adult↗
PubMed2001

Evidence on the infectious etiology of childhood leukemia: the role of low herd immunity (Greece).

OBJECTIVE: Acute lymphoblastic leukemia (ALL) among children may be a rare outcome of a delayed non-specific infection in situations of overall low herd immunity. We evaluated the hypothesis as to whether newly diagnosed ALL cases, compared to their controls, are characterized by lower herd immunity, as reflected in a more seronegative spectrum to several agents, with the exception of a strongly positive response to a single infectious agent, assumed to trigger ALL. METHODS: The study included 94 incident cases of ALL, from all pediatric hematology-oncology units of Greece, and 94, matched for age and gender, controls hospitalized with minor non-infectious conditions. The past exposure to common infections was assessed using 10 serological markers. RESULTS: There was little evidence for an association of ALL with the serology of any of the studied infectious agents among the very young children. In contrast, among children aged 5 years or older, leukemia was inversely associated with seropositivity to Epstein-Barr virus, human herpes virus-6, Mycoplasma pneumoniae and parvovirus B19. CONCLUSIONS: Among children aged 5 years or older the risk of leukemia may be higher when the low herd immunity for several agents is challenged by late infection from an agent that, as a rule, would attack children at a younger age.

Case-Control Studies↗
PubMed2001

Sports injuries among children in six European union countries.

Since sports participation entails the risk of injuries that account for substantial morbidity and disability, the existence of adequate epidemiological information is essential for the development of sound preventive strategies. In this study, we present data on the occurrence of sports injuries among children in six European countries, namely Austria, Denmark, France, Greece, The Netherlands, and the United Kingdom. An operational definition for sports injuries was developed, and comparable data from the European Home and Leisure Accident Surveillance System, an established injury surveillance system operating in 12 European union countries, were collected from the participating member states, during a 1-year period (1998). Sports injuries were examined in schools, in organised and unorganised settings, and in specific types of sports by demographics and injury descriptive variables. Sports injuries represent a quantitatively important and sufficiently serious problem in European union countries, accounting for an estimated annual number of about a quarter of a million outpatient visits in two of the participating countries, which provide national estimates. It is evident, that sport injuries are not only common but also injuries of considerable severity, since a large fraction represents fractures, while approximately 4% of the total require hospitalisation. Football and basketball among male children are, in declining order, the two sports responsible for the most frequent injuries in the European union countries, whereas gymnastics and volleyball prevail among females. The study indicates the importance of injury surveillance in describing the epidemiology of sports injuries and provides an estimate of the magnitude and the profile of sport injuries that take place annually in European union countries.

Adolescent↗
PubMed2001

The role of gene-environment interaction in the aetiology of human cancer: examples from cancers of the large bowel, lung and breast.

It has become increasingly clear that cancer can be considered neither purely genetic nor purely environmental. A relatively new area of cancer research has focused on the interaction between genes and environment in the same causal mechanism. Primary candidates for gene-environment interaction studies have been genes that encode enzymes involved in the metabolism of established cancer risk factors. There are common variant forms of these genes (polymorphisms), which may alter metabolism and increase or decrease exposure to carcinogens, thus impacting the risk of cancer. We present an overview of enzymes involved in carcinogen metabolism, present epidemiological tools to evaluate gene-environment interactions, and provide examples from cancers of the breast, lung and large bowel.

Breast Neoplasms↗
PubMed2001

Are dietary influences on the risk of prostate cancer mediated through the insulin-like growth factor system?

OBJECTIVES: To investigate whether dietary factors that appear to affect the risk of prostate cancer may be similarly associated with serum levels of insulin-like growth factor 1 (IGF-1). Patients and methods In the context of a case-control study, 112 men were admitted to three teaching hospitals in Athens, Greece, for disorders other than cancer. Sociodemographic data and detailed histories of smoking, alcohol and coffee consumption were recorded. A validated food-frequency questionnaire was administered by an interviewer and serological measurements of IGF-1 and its binding protein-3 conducted. RESULTS: IGF-1 declined significantly by almost 25% among men aged >75 years and there was a small reduction in IGF-1 levels with increased alcohol intake, with a mean (95% confidence interval, CI) change of -1.6 (- 2.2 to -0.9)% for an increment of one drink per day. There was no evidence for an effect of either smoking or coffee consumption on IGF-1 level. Among foods, the consumption of cooked tomatoes was substantially and significantly inversely associated with IGF-1 levels, with a mean (95% CI) change of -31.5 (- 49.1 to -7.9)% for an increment of one serving per day. CONCLUSIONS: The strongest known dietary risk factor for prostate cancer (lycopene deficit, as reflected in a reduced intake of cooked tomatoes) and an important endocrine factor in the aetiology of this disease (IGF-1) seem to be related in a way that suggests that at least one, and perhaps more, exogenous factors in the development of prostate cancer may be mediated through the IGF-1 system.

Adult↗
PubMed2001

The risk of liver and bile duct cancer in patients with chronic viral hepatitis, alcoholism, or cirrhosis.

No prospective study has analyzed simultaneously chronic viral hepatitis and alcoholism as risk factors for liver carcinogenesis, while taking into consideration the role of cirrhosis. Nor has the risk for hepatocellular carcinoma among patients with chronic viral hepatitis been prospectively evaluated in a low-risk Western population. Last, the relationship between hepatocellular carcinoma risk factors and bile duct cancer remains to be clarified. We analyzed prospectively the risk for primary liver and extrahepatic biliary tract cancer among 186,395 patients hospitalized with either chronic viral hepatitis, alcoholism, cirrhosis, or any combination of these conditions through linkages between national Swedish registers. Compared with the general population, the relative risk of hepatocellular carcinoma was 34.4 for chronic viral hepatitis alone, 2.4 for alcoholism alone, and 40.7 for cirrhosis alone. Among patients with combinations of these risk conditions, the relative risk of hepatocellular carcinoma was 27.3 for chronic viral hepatitis and alcoholism, 118.5 for chronic viral hepatitis and cirrhosis, 22.4 for alcoholism and cirrhosis, and 171.4 for all 3 conditions. We found limited evidence for an excess risk of intrahepatic, but not for extrahepatic, biliary duct cancer. Cirrhosis amplifies the risk of hepatocellular carcinoma among patients with chronic viral hepatitis, but it is not a prerequisite for liver carcinogenesis. In contrast, cirrhosis may be a necessary intermediate for the development of hepatocellular carcinoma among alcoholics.

Adult↗
PubMed2001

Lymphocyte alterations after prolonged sunlight exposure.

BACKGROUND: It has been suggested that prolonged exposure to sunlight may induce systemic or local immune alterations, which may facilitate the development of skin cancer and, perhaps, non-Hodgkin's lymphona. The effects of prolonged sunlight exposure on peripheral blood cells were studied. METHODS: Leukocytes and lymphocyte subpopulations of 12 volunteers aged 10-45 were investigated before and after a 3-week summer holiday in seaside resorts in Greece. Lymphocyte phenotypes were estimated using monoclonal antibodies and flow cytometry. RESULTS: There were no significant differences with respect to total numbers of T cells, T-helper/inducer, T-suppressor/cytotoxic, B cells or HLA-Dr+ cells. However, we have found evidence of lymphocyte stimulation, reflected in an increase in cells expressing the interleukin-2 receptor (IL-2R) and, more specifically, an increase in the T cells expressing IL-2R and HLA-Dr antigens. An increase in natural killer cells has also been noticed. CONCLUSIONS: These findings suggest that prolonged intense exposure to sunlight may be associated with immunostimulation, rather than immunosuppression.

Adolescent↗
PubMed2001

Physical activity and energy intake selectively predict the waist-to-hip ratio in men but not in women.

BACKGROUND: The waist-to-hip ratio (WHR) has emerged as an important risk factor for several chronic diseases, but little quantitative information exists about its relation with energy intake and expenditure in men and women. OBJECTIVE: We examined the relative role of energy intake and physical activity as determinants of WHRs in men and women, after adjustment for body mass index (BMI) and other likely confounding factors. DESIGN: In the context of the European Prospective Investigation into Cancer and Nutrition (EPIC), 16433 women and 11520 men aged 30-82 y, apparently healthy and from all over Greece, were examined between 1994 and 1999. Anthropometric measurements were taken, a validated semiquantitative food-frequency questionnaire was administered, and time-weighted occupational and leisure activities were assessed. The WHR was regressed, separately for men and women, on energy intake and energy expenditure after age and BMI were controlled for. RESULTS: Results for women and men differed. In women, neither energy intake nor energy expenditure was associated with the WHR in any way other than that mediated through BMI. In contrast, in men, higher energy intakes and higher energy expenditures were associated significantly, and largely independently of BMI, with higher and lower WHRs, respectively. CONCLUSIONS: Because the WHR is an important predictor of several cardiovascular and other chronic diseases, documentation of a strong effect of physical activity on the WHR selectively in men may provide a partial explanation of how the effect of physical activity is mediated and why physical activity is more effective in men than in women in reducing disease risk.

Activities of Daily Living↗
PubMed2001

Testosterone and oestradiol in relation to tobacco smoking, body mass index, energy consumption and nutrient intake among adult men.

There is substantial evidence linking steroid hormones and diet to cancer aetiology. The evidence on lifestyle determinants of steroid hormones, however, is limited. We have conducted a study to identify dietary and other lifestyle predictors of testosterone and oestradiol among adult men. Subjects were 112 healthy Greek men, recruited as controls in a case-control study on the aetiology of liver cancer. Demographic data and detailed histories of smoking habits and alcohol consumption were recorded. Diet was assessed through an interviewer-administered validated food-frequency questionnaire. Serologic measurements of oestradiol, testosterone and sex hormone binding globulin were also conducted. We developed linear regression models to evaluate the associations of smoking and dietary factors with serum testosterone and oestradiol. The results indicate that, among men, both testosterone and oestradiol serum levels decline with age, whereas body mass index may be inversely related with testosterone and positively with oestradiol. The evidence concerning alcohol in relation to these hormones is inconclusive. Emerging evidence concerning smoking suggests positive associations with both hormones in the blood. The principal nutritional findings are a positive association of carbohydrate intake with testosterone levels and a set of inverse associations of vitamins with oestradiol.

Adult↗
PubMed2001

Age at menarche and age at menopause in relation to hepatocellular carcinoma in women.

OBJECTIVES: To assess whether age at menarche, age at menopause, parity, and selected blood hormones are associated with risk of hepatocellular carcinoma among women. DESIGN: Case-control. SAMPLE: and setting Data collected from 50 cases of hepatocellular carcinoma among women and 62 female controls with minor trauma or surgical conditions who attended one of three hospitals in Athens, Greece between 1995 and 1998. METHODS: Researchers collected information on Reproductive variables and assayed sera samples for blood hormone levels and for chronic infection with Hepatitis B and C viruses. RESULTS Individuals with hepatocellular carcinoma had a lower mean age at menarche and a significantly higher mean age at menopause. After adjusting for potential confounding, age at menopause remained an important and significant predictor, increasing the risk of hepatocellular carcinoma 24% for each later year of menopause (P < 0.001). For each year that menarche was delayed, risk of hepatocellular carcinoma declined 21% (P = 0.100). Mean levels of insulin-like growth factor-1 and its binding protein were significantly reduced in cases compared with controls, while levels of oestradiol, testosterone and sex hormone binding globulin were somewhat higher among the cases. CONCLUSIONS: This study provides indirect, but converging evidence that steroid hormones in general, and oestrogens in particular, play an important role in the aetiology of hepatocellular carcinoma among women.

Age Factors↗
PubMed2001

Are there common triggers of preterm deliveries?

OBJECTIVE: To assess the effect(s) of transient events which are perceived as stressful on the inseption of preterm delivery. DESIGN: A case-control study, with immature infants as cases and borderline term babies as controls. SETTING: A teaching maternity hospital in Athens. POPULATION: All infants born at less than 37 weeks of gestation, during a twelve-month period. METHODS: Information was collected about maternal socio-demographic and lifestyle characteristics, clinical variables and stressful events occurring within two weeks prior to delivery. MAIN OUTCOME MEASURES: Factors affecting the risk of preterm delivery. RESULTS: Extreme prematurity (<33 weeks) is more common among younger (<25 years of age) and older (>29 years of age) women and is positively associated with parity, body mass index and smoking, whereas it is inversely associated with educational level, regular physical exercise and serious nausea/vomiting. After controlling for these factors, however, only coitus during the last weeks of pregnancy had a significant triggering effect on prematurity (P = 0.004, odds ratio 3.21, 95% CI 1.45 to 7.09 for very immature babies, and P = 0.04, OR = 2.20, 95% CI 1.03 to 4.70 for immature babies). On the contrary, several events perceived as stressful, such as illness of relatives or friends, husband's departure, loss of employment, were unrelated to the onset of premature labour. CONCLUSIONS: Coitus during the last few weeks of pregnancy appears to increase the risk of preterm delivery, while a possible detrimental effect of physical exertion seems more limited. Stressful events should not receive undue attention as possible causes of preterm delivery.

Adult↗
PubMed2001

Insulin-like growth factor binding protein-3 predicts survival from acute childhood leukemia.

OBJECTIVE: To investigate whether the three principal components of the insulin-like growth factor (IGF) system, IGF-1, IGF-2 and IGF binding protein-3 (IGFBP-3), are associated with survival from childhood leukemia. PATIENTS AND METHODS: 116 children, 0--14 years old, with newly diagnosed and bone-marrow-biopsy-confirmed acute childhood leukemia between 1993 and 1996 were followed up until death or March 31, 1998. IGF-1, IGF-2 and IGFBP-3 were measured at diagnosis and clinical data, including presence of hepatosplenomegaly and number of white blood cells, were available. RESULTS: After controlling for gender, age, indicators of clinical severity and the other measured components of the IGF system there was a statistically significant (p < 0.05) inverse association of IGFBP-3 with survival. An increment of one standard deviation in IGFBP-3 was associated with a 65% reduction of the death hazard among the children with leukemia. Neither IGF-1 nor IGF-2 was associated with survival in this data set. CONCLUSION: The presented empirical evidence in conjunction with the fact that IGFBP-3 modulates IGF-1 and IGF-2 bioavailability and is likely to have proapoptotic effects makes this compound a plausible independent predictor of survival from childhood leukemia.

Adolescent↗
PubMed2001

Estrogens, testosterone and sex hormone binding globulin in relation to liver cancer in men.

OBJECTIVE: Liver disease in men has been associated with an imbalance of serum estradiol and testosterone. We have evaluated whether serum estradiol and testosterone levels are altered in male liver cancer patients as a result of a specific effect of the disease or because of the associated liver damage. METHODS: We have performed a hospital-based case-control study in Greece. The study subjects were all men; 73 patients with hepatocellular carcinoma (HCC), 25 with metastatic liver cancer (MLC) patients and 111 control subjects. Serum estradiol, testosterone and sex hormone binding globulin (SHBG) levels were measured for each subject. Data were analyzed by multiple linear regression. RESULTS: Mean serum estradiol levels were significantly higher among HCC patients as well as among patients with MLC compared to controls. Mean serum testosterone levels were significantly lower among HCC patients as well as among patients with MLC compared to controls. The mean SHBG levels did not differ significantly between the groups. After controlling for the degree of liver damage, the elevated serum estradiol and reduced serum testosterone levels among HCC and MLC patients were no longer significant. CONCLUSIONS: Changes in sex steroid levels among patients with liver damage are due to the liver damage per se and not to specific disease processes.

Adult↗
PubMed2001

Person, time and place coordinates of pedestrian injuries: a study in Athens.

UNLABELLED: The aim of this study was to investigate whether socioeconomic status of town of residence is associated with risk for childhood pedestrian injuries. The study population consisted of all pedestrian victims, aged 0-14 y, who lived in towns of Greater Athens and who presented to the Emergency Department of a major Children's Hospital during the period 1996-98. The towns were divided into three categories by socioeconomic status according to the proportion of (a) adult household heads with a higher education degree and (b) households with less than one person per room. The rate of pedestrian injuries was estimated by socioeconomic status of the residential town and by place of accident (inside or outside the respective town). The pedestrian injury rate ranged from 5.5 to 12 injured children among a 10000 childhood population per year, with an almost twofold excess among children residing in the less wealthy towns compared with the wealthier ones. The social gradient was steeper for injuries occurring outside the residential town. The population fractions of pedestrian injury rates attributable to educational level and household crowding differentials, regardless of the place of accident, were 39% and 25%, respectively. CONCLUSIONS: There is a considerable social gradient for childhood injuries irrespective of place of accident, a finding that could be partly attributable to lower socioeconomic background rather than to adverse environmental factors prevailing in less wealthy towns. Our findings indicate that there is a need for preventive programmes targeting people as well as places of low socioeconomic status.

Accidents, Traffic↗