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Biomedical subjects

E S Pollack

Publications and source records attributed to E S Pollack.

34 records · Page 2Linked to original sources
PubMed1984

Prospective study of alcohol consumption and cancer.

The relation between alcohol consumption and the subsequent occurrence of the five most frequent cancers in Japanese men in Hawaii (cancer of the stomach, colon, rectum, lung, and prostate) was analyzed in a prospective study of 8006 subjects. Information on alcohol consumption was obtained through interviews in the mid-1960s, and the cohort has been followed since then. The analysis, which was adjusted for the effects of age and cigarette smoking, revealed a positive association between consumption of alcohol and rectal cancer, accounted for primarily by an increased risk in men whose usual monthly consumption of beer was 500 oz (15 liters) or more (relative risk, 3.05; P less than 0.01, as compared with those who did not drink beer). A significant positive relation between alcohol consumption and lung-cancer incidence was also found, accounted for primarily by an increased risk among subjects who consumed larger amounts of wine or whiskey, as compared with the risks among nonconsumers of these beverages (relative risk, 2.19, [P = 0.03] and 2.62 [P less than 0.01], respectively). No significant relation between alcohol consumption and the incidence of the other three cancers was found.

Aged↗
PubMed1984

Cancer patient survival among ethnic groups in the United States.

Data from the Surveillance, Epidemiology and End Results Program of the National Cancer Institute were used in the evaluation of cancer patient survival experience for 8 racial-ethnic groups in the U.S. population--Anglos, Hispanics, blacks, American Indians, Chinese, Japanese, Filipinos, and Hawaiians. This report contains an actuarial (life table) survival analysis on 402,752 patients with first primary cancer diagnosed in 1973-79 and followed through December 31, 1981. Relative and observed survival rates are shown for each sex separately by primary site. Survival rates for females exceeded those for males for each primary site except for gallbladder and urinary bladder. The primary site having the highest survival rate among each group studied was the thyroid gland with a 5-year relative rate of 91% for all races combined. Rates were uniformly low among each group for cancers of the esophagus, liver, and pancreas. Survival rates for Hispanics were almost identical to those for Anglos; the largest differences were found for bladder (73% for Anglos vs. 64% for Hispanics), Hodgkin's disease (70% for Anglos vs. 61% for Hispanics), and ovary (35% for Anglos vs. 42% for Hispanics). For many primary sites Japanese experienced the highest survival rates and American Indians the lowest. In comparison to Anglos, Japanese had higher survival for cancers of the stomach, colon, prostate gland, and breast. The higher survival for stomach and breast cancers persisted even when controlling for age of patient and stage of disease at diagnosis. Survival rates for blacks were much lower than those for whites for cancers of the corpus uteri and urinary bladder. Survival rates for Chinese and Hawaiians were roughly comparable to those for Anglos, whereas survival rates for Filipinos tended to be similar to those for blacks.

Adult↗
PubMed1984

Assessing the validity of observed cancer incidence trends.

The available cancer incidence data from the National Cancer Institute surveys, the Surveillance, Epidemiology, and End Results (SEER) Program, and the Connecticut Tumor Registry are examined for the period from the late 1940s to the present. Two indicators of completeness and accuracy of reporting (percentage of cases reported only by death certificate and percentage of cases with histologic confirmation of the diagnosis) show considerable variation, particularly in the past, but no consistent strong patterns indicating noncomparability of the data are apparent. Incidence data for five geographic areas (Atlanta, Detroit, San Francisco-Oakland, Iowa, and Connecticut) are examined for several primary sites by area and age, and are compared with mortality data for the same areas and the entire country. A variety of patterns in the trends are apparent. For several sites, the incidence trends are similar to what would be predicted based on the mortality patterns, but differences are apparent for other sites. Mortality trends may be influenced by shifts in diagnostic specificity on the death certificates and by changes in survival rates, and both incidence and mortality rates may be influenced by increased casefinding, improvements in diagnostic procedures, expansion of the medical care delivery system, and real changes in the prevalence of risk factors. Therefore, both incidence and mortality data should be used when attempting to assess the real trends in cancer occurrence because sole reliance on one or the other may lead to erroneous conclusions.

Adult↗
PubMed1983

Cancer patient survival: Surveillance, Epidemiology, and End Results Program, 1973-79.

Data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute were used in the evaluation of cancer patient survival experience for almost 10% of the U.S. population. This first report contains actuarial (life table) survival analysis on 368,263 patients with first primary cancer diagnosed in 1973-79 from nine SEER areas: the entire States of Connecticut, Iowa, New Mexico, Utah, and Hawaii and the metropolitan areas of Atlanta, Detroit, San Francisco, and Seattle. Both observed and relative survival rates were shown for whites and blacks, sex, age, primary site, and time period (each yr, 1973-78). The largest racial difference in survival was for cancer of the corpus uteri: 87% 5-year relative survival rate for white females versus only 54% for black females. Survival rates varied considerably by primary site. For most sites, as age increased the relative and observed survival rates decreased. Analysis of relative survival rates by ech year of diagnosis, 1973-78, and for each year following diagnosis suggested increasing rates for cancers of the colon, lung, and prostate gland, whereas there were no definite increases for cancers of the female breast and corpus uteri. A dramatic increase in survival from acute lymphocytic leukemia was found for children under 15 years of age, with the 4-year relative survival rate increasing from 51% among those diagnosed in 1973-75 to 65% for those diagnosed in 1976-78.

Adolescent↗
PubMed1981

Serum cholesterol and colon cancer incidence in Hawaiian Japanese men.

A prospective study of cancer and coronary heart disease (CHD) in 8,006 Hawaiian Japanese men, aged 45-68 years, showed that serum cholesterol levels below 180 mg/dl predicted low rates of CHD and high rates of colon cancer. Men with colon cancer had lower mean serum cholesterol levels than did other members of the cohort, including those with cancer at other sites. The lowest serum cholesterol levels were obtained from men who died as a result of colon cancer. The lack of such an association with other cancers and the persistence of this inverse association in colon cancer patients diagnosed 5-9.9 years after examination suggest that the low serum cholesterol was not due to preexisting disease. Right colon tumors showed the strongest inverse association with serum cholesterol. The differences between CHD and colon cancer in respect to serum cholesterol indicate that different subsets of the westernized Japanese population are affected.

Aged↗
PubMed1980

Trends in cancer incidence and mortality in the United States, 1969-76.

Trends in cancer incidence and mortality in the United States were analyzed over the period 1969 through 1976. The greatest increase in incidence among whites occurred for lung cancer among females (almost 9%/yr), whereas the incidence of cancer of the uterine corpus increased 6% per year. Cancer of the cervix showed the greatest decrease in incidence, an average of 6% per year. Stomach cancer incidence and mortality showed a substantial decline for each sex, and rectal cancer incidence increased for each sex whereas mortality declined. The incidence of cancer of the female breast increased 1.8% per year without inclusion of the rates for 1974 and 1975, when an unusually large increase occurred. Cancer mortality data were presented for the total United States on the basis of data from the National Center for Health Statistics. Emphasis was focused on the comparability of cancer incidence data over the time period studied, given the fact that cancer incidence was measured by the Third National Cancer Survey for the period 1969-71 and by the Surveillance, Epidemiology, and End Results Program for the period 1973-76. Each survey covered approximately 10% of the U.S. population but had four geographic areas in common. Investigation of the comparability of these two surveys revealed that the incidence rates for whites were sufficiently comparable to permit an analysis of trends in cancer incidence over the entire period 1969-1976. Such comparability was not found for blacks. Therefore, cancer incidence data are presented only for whites, but cancer mortality data are presented for both whites and blacks.

Breast Neoplasms↗
PubMedDate not supplied

Ketotic hypoglycemia: a case report.

Ketotic hypoglycemia (KH) is recognized in the pediatric literature as the most common cause of childhood hypoglycemia. Since the first manifestation of the syndrome is classically that of new onset seizures, initial emergency department presentation is likely. We describe a representative case and emphasize the importance of routine serum glucose and urine ketone measurements in young children with new onset seizures.

Child, Preschool↗
PubMedDate not supplied

Henoch-Schönlein purpura: four cases and a review.

Henoch-Schönlein Purpura (HSP) is a common, usually self-limited, vasculitis affecting children and young adults. Manifested by a characteristic rash, the course of HSP is typically a benign one, but may be accompanied by varying degrees of abdominal pain, arthritis or arthralgia, gastrointestinal bleeding, and nephritis. The various manifestations of HSP may present at any stage during the illness and mimic other disease processes, some of which may be life threatening. Thus, the emergency physician must consider the diagnosis of HSP in order to detect complications and avoid needless intervention in what usually is an otherwise benign process. We present four cases and a brief review of the literature to highlight HSP in the differential diagnosis of patients who present with any of the typical clinical signs and symptoms.

Adolescent↗
PubMedDate not supplied

Vogt-Koyanagi-Harada syndrome: case report and review.

The case of an adolescent male with a painful red eye is presented, and the emergency department differential diagnosis is reviewed. The patient had Vogt-Koyanagi-Harada (VKH) syndrome, a panuveitis with extraocular systemic manifestations. The syndrome may result in permanent visual loss but is quite sensitive to corticosteroid therapy. Early ophthalmologic consultation from the emergency department is essential for prompt institution of definitive therapy and preservation of vision. The salient features and diagnostic evaluation of VKH are reviewed.

Adolescent↗
PubMedDate not supplied

Antibiotic use in the emergency department: I. The penicillins and cephalosporins.

The penicillins and cephalosporins are beta-lactam agents that provide broad-spectrum antimicrobial coverage pertinent to many infectious diseases diagnosed in the emergency department. These groups of drugs also have in common their classification into subcategories or "generations" that delineate their usefulness in specific clinical scenarios such as infections with Gram-positive or -negative bacteria, Pseudomonas infections, or febrile neutropenic patients. Understanding these subcategories is essential to both efficacious and cost-effective use of these agents. This article reviews the pharmacology and clinical utility of the beta-lactams--including a new class of antibiotics, the carbacephams--for the emergency physician.

Ampicillin↗
PubMedDate not supplied

The epidemiology of cancer and the delivery of medical care services.

Data collected primarily for epidemiologic purposes can be used to address questions concerning medical care for cancer in the United States. This was done directly for the period 1969-71 through an interview survey of a sample of cancer patients identified in the Third National Cancer Survey to obtain information on length of hospital stay, cost of care, source of payment, and related issues. Since that time the Surveillance, Epidemiology, and End Results (SEER) Program was established by the National Cancer Institute to measure cancer incidence and cancer patient survival in 10 percent of the U.S. population on a continuing basis. Using the SEER data and those from the earlier cancer surveys, evidence is presented for the increasing need for medical care resources for some of the major cancers, such as cancers of the lung and prostate. Data from the National Hospital Discharge Survey for 1979 reveal an average length of stay of 12.3 days for each hospital discharge with a diagnosis of cancer, ranging from 8.5 days for those with cancer of the cervix uteri to 20 days for those with brain cancer. Some suggestions are made for applying hospital data on length of stay from the National Hospital Discharge Survey to estimates of cancer incidence from the SEER Program to obtain estimates of numbers of hospital days required during the first period of hospitalization for cancer. This estimate for the United States for 1983 was almost 11 million hospital days for all cancers combined.

Adult↗