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Biomedical subjects

D V Vakil

Publications and source records attributed to D V Vakil.

At least 19 recordsLinked to original sources
PubMed1988

Automatic piercing spinhaler (Halermatic): a comparative study.

Fifty patients, 27 females and 23 males with a mean age of 30 years and a history of chronic asthma, were studied during treatment with cromolyn sodium administered via the standard spinhaler and a new automatic piercing spinhaler, Halermatic. The study period consisted of a baseline period of 3 weeks (spinhaler use) and an 8-week period of Halermatic use. In the final analysis of results, it was noted that fewer inhalations (P less than .001) were needed to empty the cromolyn Spincaps with the Halermatic and a higher number of patients (61%) preferred the Halermatic over the Spinhaler.

Adolescent↗
PubMed1988

Lung cancer mortality trends in Canada from 1931 to 1982.

Lung cancer is the leading cancer that causes premature death in Canadian men, and it is the second leading cancer that causes death in Canadian women. To assess the long-term mortality of this disease, we collected and analyzed data from 1931 to 1982. A 3-year base period was used to obtain person-years exposure using the Newton-Cotes method. All rates were standardized to the 1956 Canadian population for age and sex using the direct method. Standard errors of age-standardized death rates (ASDR) were computed using Chiang's method. The ASDRs have increased both for men and women. The increases in older age groups are due to a large, absolute increase in lung cancer-caused mortality in both sexes. Although the absolute increase in lung cancer is greater in men, the percentage of increase is greater in women, especially in the younger age groups. The mortality trends for lung cancer in both men and women appear to be consistent with the tobacco consumption in the population. Given the relatively low survival rates for lung cancer, preventive strategies are urgently required.

Age Factors↗
PubMed1988

Cancer mortality trends in Canada: breast cancer, 1925-1982.

Breast cancer is the number one cause of death in Canadian women aged 20-74 years (for all 5-year age groups) and the second leading cause for those aged 75 years and over. To assess the long-term mortality of this disease, we collected and analyzed data from 1925 to 1982. A 3-year base period was used to obtain person-years exposure using Newton-Cotes' method. All rates were standardized to the 1956 Canadian population for age and sex using the direct method. Standard errors of age-standardized death rates (ASDR) were computed using Chiang's method. Mortality from breast cancer has been quite stable during the study period (at about 23.7 deaths/100,000 population). The lowest ASDR occurred in 1926 (at 17.5 deaths/100,000 population); the highest occurred in 1946 (when it reached 26.6 deaths/100,000 population). During 1951-1981, the ASDR fluctuated between 22.8 and 24.0 deaths/100,000 population. Examination of age sex-specific rates revealed a steady trend for 25-44-year-old females and a rise in mortality in the older age groups. It is suggested that part of this rise may be associated with changes in environment, life-style, and therapy.

Adult↗
PubMed1985

Use of ipratropium aerosol in the long-term management of asthma.

In order to assess the efficacy and safety of ipratropium in the long-term management of chronic asthma, 20 stable and ambulatory asthmatics were followed for 1 year. Clinical and spirometric examinations were performed on all 20 patients at the start of the study and on six other occasions. FEV1, FVC, MMFR, heart rate, and blood pressure were recorded immediately before and 30, 60, 120, and 180 min after the administration of 40 micrograms of ipratropium. During these visits, patients were asked to rate their breathing during the preceding period, describe (any) side effects, and assess the impact of ipratropium in their inhalation. During their visits, significant improvements in FEV1 and FVC (p less than 0.05) were noted for a majority of the patients. As the study progressed, more and more patients were observed to experience significant improvements in their FEV1, FVC, and MMFR. All ECG measurements and biochemical tests were normal. Side effects of minimal severity were reported on two occasions during the 100 patient-visits. Our study indicates that an ipratropium-based regimen is efficacious, safe, and well received by chronic asthmatics.

Adult↗
PubMed1985

A double-blind comparative study of pelletized cromolyn versus cromolyn blend in the treatment of asthma.

In a randomized, double-blind, group comparative study, 100 asthmatic patients known to be responsive to cromolyn sodium were treated either with pelletized cromolyn (cromolyn sodium, 20 mg) or with cromolyn blend, Intal (cromolyn sodium, 20 mg + lactose, 20 mg). There was no statistically significant difference between the two treatment groups for asthma severity, breathlessness on exertion, cough, the number of inhalations needed to obtain the dose from the capsule, and morning peak flow. No local or systemic side effects were encountered during the 6-month duration of the study. It is concluded that pelletized cromolyn offers most of the advantages of cromolyn therapy without the need for the patients to inhale lactose at the same time. Also, pelletized cromolyn has a distinct therapeutic advantage for use in lactose-in-tolerant patients.

Administration, Intranasal↗
PubMed1984

Treatment of seasonal conjunctivitis: comparison of 2% and 4% sodium cromoglycate ophthalmic solutions.

In a double-blind, noncrossover, group study a 2% ophthalmic solution of sodium cromoglycate (Opticrom) was compared with a 4% solution in the treatment of ragweed-pollen-induced conjunctivitis. The 22 female and 18 male patients, ranging in age from 10 to 61 years, had a history of troublesome eye symptoms during the ragweed season for at least 2 years and had previously obtained minimal relief with the 2% solution. They were randomly assigned to two treatment groups in matched pairs and instructed to use one drop of the medication in each eye four times a day for 4 weeks. Treatment efficacy was evaluated from the patients' daily diaries, periodic clinical assessments and subjective reports by the patients at the end of the trial. Analysis of the symptom severity scores and evaluations by both the patients and the clinician indicated that the 4% solution was more effective than the 2% solution in controlling the symptoms. No local or systemic side effects were encountered.

Adolescent↗
PubMed1983

Exogenous estrogens and development of breast and endometrial cancer.

The risk of breast cancer and endometrial cancer in 1483 menopausal and postmenopausal women who had received estrogen therapy for other than contraceptive use was examined. The incidence and mortality rates of the study cohort (cohort A) were compared with the age-specific cancer incidence and mortality rates of the female populations of Ontario (cohort B) and of Saskatchewan (cohort C). A significant difference was found in each of the two comparisons between the observed and expected survival curves for breast cancer incidence and breast cancer mortality. However, the incidence rate of endometrial cancer in the study cohort (cohort A) did not differ significantly from the rates of the reference populations (cohorts B and C). The results suggest that the women in the study may have received some protective effect against breast cancer by taking estrogens, but the estrogens did not protect them against endometrial cancer and may indeed have predisposed them to this cancer.

Adult↗
PubMed1981

Cystic disease, family history of breast cancer, and use of oral contraceptives.

Epidemiologic studies show a lower frequency of fibrocystic breast disease among users of oral contraceptives than among women who have never used them. Family history of breast cancer appears to be more common among benign breast disease patients than among their controls. To determine the use of oral contraceptives and the presence of family history of breast cancer, information was obtained from 211 cystic cases and their matched controls from the metropolitan Toronto area. Cystic cases compared to controls had a higher proportion of women with a family history of breast cancer (21% vs 15%). For both a positive and negative family history of breast cancer, as well as for all women combined, the mean duration of oral contraceptive use was lower for cystic cases than for controls. The odds ratio for oral contraceptive use according to family history of breast cancer for cystic cases and controls was 0.42 and 0.81 respectively. The possibility that a woman is more protected against benign breast disease by using oral contraceptives if she has a family history of breast cancer deserves more attention in future investigations on the long-term effects of birth control pills.

Breast Diseases↗
PubMed1981

Benign breast disease: estriol proportions and family history of breast cancer.

Urine samples were analyzed for estrone (E1), estradiol (E2), and Estriol (E3) to test the hypothesis that women diagnosed with benign breast disease (high risk for breast cancer?) will have lower estriol proportions (E3/E1 + E2 + E3) than a comparison control group. Luteal urine samples were collected from 64 women recently diagnosed with benign breast disease (cases) and from 64 controls matched for age and education. Compared to their controls, benign breast disease patients had a lower mean weight (P less than 0.05), lower Quetelet's index (P less than 0.02), and higher frequency of family history of breast cancer (P less than 0.01) and of family history of any breast disease (P less than 0.01). The mean estriol proportions were similar for cases and controls before and after stratification by family history and Quetelet's index. Results of this study indicate that if women with benign breast disease are at high risk of breast cancer, that risk is not transmitted by the estriol proportion.

Adult↗
PubMed1978

Estrogen profiles in young women: effect of maternal history of breast cancer.

To examine the hypothesis that familial breast cancer risk is related to estrogen metabolism, we analyzed urines of daughters of breast cancer patients and their matched controls for estrone (E1), estradiol (E2), and estriol (E3). From this, we computed estriol proportions (E3/E1 + E2 + E3). "Patient-daughters" and the matched controls showed no differences in estriol proportions. Our results failed to support the hypothesis that high-risk women (those with a family history of breast cancer) have relatively lower estriol proportions, and we concluded that whatever family history contributes to breast cancer risk, that risk is not likely to be transmitted by the estrogen profile.

Adolescent↗
PubMed1974

Etiology of breast cancer. III. Opportunities for prevention.

Breast cancer, or its effects, may be preventable. Childbearing at an early age will confer some protection. Until there are other methods of primary prevention the physician must concentrate on secondary prevention, including screening. In presenting risk factors as criteria for screening we have attempted to make rational the use of screening technology. We should not easily accept screening for breast cancer as of proved value. Rather we must encourage clinical trials of various screening methods. In the meantime, while we engage in a moderate amount of screening we do so under the Scottish verdict of "not proven".

Adult↗
PubMed1973

Etiology of breast cancer. II. Epidemiologic aspects.

The epidemiology of breast cancer is reviewed with particular emphasis on its etiology. A number of studies suggest that differences in breast cancer incidence are associated with differences in marital status, number of pregnancies, age at menarche, age at menopause, height and weight, socioeconomic status, geographic location and residence. However, in no case is the evidence adequate to establish a "cause and effect" relationship. The genetic component of these associations may be of primary importance, while other conditions such as marital status are probably indirect reflections of the operation of more fundamental factors.There is a general consensus that endocrine factors play an important part in mammary cancer occurrence. At present, the association between breast cancer and the presence of the virus-like (type B) particles in human milk is not established.

Adult↗
PubMed1973

Etiology of breast cancer. I. Genetic aspects.

The subject of breast cancer is reviewed with particular emphasis on the genetic aspect of its etiology. A number of studies using various approaches gave the same results: the familial form occurs earlier and there is a higher risk in female members of the breast-cancer families. An association between breast cancer and cancer of certain other sites among women is reported. Cytogenetic studies of "cancer families" revealed increased frequency of aneuploidy in some members. However, the role of chromosome abnormalities in carcinogenesis is still not clear.

Adenocarcinoma↗