Biomedical subjects

F Grodstein

Publications and source records attributed to F Grodstein.

45 records · Page 3Linked to original sources

PubMed1994

Continuation and initiation of alcohol use from the first to the second year of college.

Widespread and heavy alcohol use among American college students is a source of concern to college administrators and public health officials. This study surveyed a cohort of 611 college students during their first and second year of college in order to examine the development of alcohol use behaviors in college. Almost every student who used alcohol during the first year continued to do so during the second year. Similarly, many of the students who were binge drinkers the first year continued binge drinking the second year. One-third of male freshmen who had not binged the first year initiated this behavior during the second year, although relatively few female students did so. Compared to continued users, the students who initiated alcohol use during the second year were light users. In addition, students who drank more heavily in high school were more likely to be binge drinkers in college than students who drank lightly in high school. The results suggest that heavy alcohol use is not predominantly a behavior that is learned in college. Consequently, programs that address alcohol use among college students need to focus on early detection and intervention rather than primary prevention.

Adolescent↗

PubMed1994

Infertility in women and moderate alcohol use.

OBJECTIVE: The purpose of this study was to investigate the relationship between moderate alcohol intake and fertility. METHODS: Interviews were conducted with 3833 women who recently gave birth and 1050 women from seven infertility clinics. The case subjects were categorized based on the infertility specialist's assignment of the most likely cause of infertility: ovulatory factor, tubal disease, cervical factor, endometriosis, or idiopathy. Separate logistic regression models were used to assess the relationship between alcohol use and each type of infertility, adjusted for age, infertility center, cigarette smoking, caffeine use, number of sexual partners, use of an intrauterine device (for tubal disease), and body mass index and exercise (for ovulatory factor). RESULTS: We found an increase in infertility, due to ovulatory factor or endometriosis, with alcohol use. The odds ratio for ovulatory factor was 1.3 (95% confidence interval [CI] = 1.0, 1.7) for moderate drinkers and 1.6 (95% CI = 1.1, 2.3) for heavier drinkers, compared with nondrinkers. The risk of endometriosis was roughly 50% higher in case subjects with any alcohol intake than in control subjects (OR = 1.6, 95% CI = 1.1, 2.3, at moderate levels; OR = 1.5, 95% CI = 0.8, 2.7, at heavier levels). CONCLUSIONS: Moderate alcohol use may contribute to the risk of specific types of infertility.

Adult↗

PubMed1994

Postmenopausal estrogen and cardiovascular disease.

When data from the significant studies are assembled and analyzed, what is known about the impact of supplemental estrogen on the risk of cardiovascular disease in women after the menopause? What are the best clinical guidelines today?

Cardiovascular Diseases↗

PubMed1994

A prospective study of symptomatic gallstones in women: relation with oral contraceptives and other risk factors.

OBJECTIVE: To examine the relation between oral contraceptives (OCs), body mass index (BMI), weight change, alcohol use, parity, smoking, and symptomatic gallstones in women less than 45 years of age. METHODS: In this prospective study, associations between the various self-reported exposures and symptomatic gallstones were assessed in 96,211 female United States nurses with 425 cases of gallstones, using multiple logistic regression. RESULTS: We found little relation between ever-use of OCs and symptomatic gallstones (relative risk [RR] 1.2, 95% confidence interval [CI] 0.9-1.6), although there was a modest elevation in risk for long-term use (RR 1.5, 95% CI 1.0-2.2 for 10-14 years; RR 1.6, 95% CI 1.0-2.4 for 15 or more years). There was also an increased risk in current users of OCs (RR 1.6, 95% CI 1.1-2.4). The risk of symptomatic gallstones increased with increasing BMI and weight gain since age 18. Women with four or more births had an elevated risk of symptomatic gallstones (RR 2.0, 95% CI 1.3-3.2), and current cigarette smokers had a slightly higher risk than never-smokers (RR 1.3, 95% CI 1.0-1.7). The risk decreased with increasing alcohol intake. CONCLUSION: We found no substantial increase in the risk of symptomatic gallstones among ever-OC users, although current and long-term users had somewhat elevated risks. Body mass index remains the strongest predictor of symptomatic gallstones among young women.

Adult↗

PubMed1994

Postmenopausal hormone use and cholecystectomy in a large prospective study.

OBJECTIVE: To examine the association between postmenopausal hormone use and cholecystectomy. METHODS: A prospective cohort study was performed, with follow-up every 2 years. Participants were 54,845 postmenopausal United States nurses, who reported both hormone use and cholecystectomy on mailed questionnaires. RESULTS: Cholecystectomy was reported by 1750 women during 8 years of follow-up. After adjusting for confounding factors, women currently using postmenopausal hormones were at an increased risk of cholecystectomy (relative risk [RR] 2.1, 95% confidence interval [CI] 1.9-2.4) compared to never-users. For current users, the risk of cholecystectomy increased with increasing duration of hormone use (RR 2.6, 95% CI 2.2-3.1 for 10 years or more) and higher doses of estrogen (RR 2.4, 95% CI 2.0-2.9 for users of 1.25 mg or more). Although the risk for past hormone users decreased substantially in women who had discontinued use 1-2.9 years ago (RR 1.6, 95% CI 1.2-2.0), a small risk persisted for women who had stopped taking hormones 5 or more years previously (RR 1.3, 95% CI 1.1-1.6). However, after controlling for time since last use, duration of past use had little or no effect on the risk of cholecystectomy (RR 1.4 and RR 1.7 for past users of less than 2 years and 10 or more years' duration, respectively). CONCLUSION: Women using postmenopausal hormones are at an increased risk of cholecystectomy. Women and their physicians should consider the spectrum of risks and benefits when deciding whether to take hormones.

Cholecystectomy↗

PubMed1993

Relation of female infertility to consumption of caffeinated beverages.

Several studies have reported an association between caffeine intake and delay to conception. To study this relation further, the authors examined caffeine use in 1,050 women with primary infertility and 3,833 women who had recently given birth during the period 1981-1983 in the United States and Canada. The cases were separated by the cause of their infertility: ovulatory factor, tubal disease, cervical factor, endometriosis, or idiopathic infertility. The relative risks of each type of infertility associated with caffeine were calculated using separate logistic regression models and controlling for relevant confounding factors, such as age, center, cigarette smoking, lifetime number of sexual partners, alcohol consumption, contraception, body mass index, and exercise. A significant increase in the risk of infertility due to tubal disease or endometriosis was observed for the upper levels of caffeine intake, indicating a threshold effect. For tubal infertility, a relative risk of 1.5 (95% confidence interval (CI) 1.1-2.0) was found in women who consumed more than 7 g of caffeine per month as compared with those who consumed 3 g or less per month. For endometriosis, the relative risk was 1.9 (95% CI 1.2-2.9) in women who consumed 5.1-7 g/month and 1.6 (95% CI 1.1-2.4) in those with an intake of more than 7 g/month. These data suggest that caffeine deserves further study with regard to its effects on the female reproductive system.

Adult↗

PubMed1993

Relation of tubal infertility to history of sexually transmitted diseases.

We studied the history of sexually transmitted diseases in 283 nulliparous women diagnosed with infertility due to tubal adhesions or occlusion and 3,833 women admitted for delivery at seven collaborating hospitals. The adjusted risks of tubal infertility associated with the history of each sexually transmitted disease were estimated by the odds ratios obtained by multiple logistic regression. Women who reported prior infection with gonorrhea were at a significantly increased risk of tubal infertility (relative odds = 2.4, 95% confidence interval 1.3-4.4). In addition, the risk of tubal infertility was almost twice as high in women who recalled previous trichomoniasis compared with women with no such infection (relative odds = 1.9, 95% confidence interval 1.3-2.8). Furthermore, there was a trend of increasing risk with an increasing number of episodes of gonorrhea or trichomoniasis.

Adult↗

PubMed1993

Self-reported use of pharmaceuticals and primary ovulatory infertility.

Over 1.5 billion prescriptions were filled by pharmacies in 1990, but little information exists on the effect that pharmaceutical agents have on female reproductive capacity. As part of a case-control study of risk factors for primary ovulatory infertility, we examined self-reported use of several prescription and nonprescription medications in 597 women with ovulatory infertility and 3,833 controls admitted for delivery at seven hospitals. Only women reporting use of a drug for at least 6 months, beginning before the onset of infertility in cases and before conception in controls, were considered exposed. An elevated risk of ovulatory infertility was found for women who ever used thyroid preparations [relative risk (RR) = 2.3, 95% confidence interval (CI) = 1.5-3.5] or antidepressants (RR = 2.9, 95% CI = 0.9-8.3), although the latter estimate was based on only five cases who reported having taken antidepressants. Current users of tranquilizers and ever-users for more than 2 years were also at greater risk of infertility than never-users (RR = 3.2, 95% CI = 1.1-8.5 and RR = 2.9, 95% CI = 0.8-11, respectively). Women who used asthma medication before age 21 had more than a twofold increase in risk of ovulatory infertility (RR = 2.5, 95% CI = 1.0-5.9).

Adult↗

PubMedDate not supplied

The epidemiology of coronary heart disease and estrogen replacement in postmenopausal women.

Cardiovascular diseases remain the leading cause of death in American women. Evidence from epidemiological studies indicates that estrogen replacement therapy in postmenopausal women can reduce their risk of coronary heart disease. Current users, in particular, appear to enjoy the most substantial cardiac benefits. It remains possible that the protective effect of estrogen observed in these studies may be due, in part, to bias. Women who use estrogen see a physician regularly, and compliance with estrogen therapy may identify a low-risk group of women. Furthermore, women who choose to use estrogen may lead generally healthier lifestyles than those who do not take such medication. However, adjustment for known cardiac risk factors in many of the large studies had little impact on the results, implying an equivalent risk status for users and nonusers. In addition, both animal and human studies show that estrogen use lowers low-density lipoprotein cholesterol levels, increases high-density lipoprotein cholesterol levels, improves blood flow, and reduces atherosclerosis. The effect of progestin added to estrogen therapy has not been adequately assessed, but initial evidence suggests that it may somewhat attenuate, although not completely eliminate, the benefits of estrogen on cardiovascular disease. Finally, each individual woman differs in her particular risks and benefits, and careful consideration of each woman's unique situation is required; the fear of breast cancer should be considered, together with the knowledge that many interventions are available to reduce the risk of cardiovascular disease.

Coronary Disease↗