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Biomedical subjects

F Sturmans

Publications and source records attributed to F Sturmans.

At least 55 records · Page 3Linked to original sources
PubMed1994

Validation of a dietary questionnaire used in a large-scale prospective cohort study on diet and cancer.

OBJECTIVE: The study was conducted to assess the validity of a self-administered 150-item food frequency questionnaire (FFQ), used in a cohort study on diet and cancer (120,852 men and women, aged 55-69). DESIGN & SUBJECTS: The study was carried out in a subgroup of the cohort (59 men and 50 women) 2 years after the baseline FFQ was completed. A dietary record, kept over three 3-day periods, 4-5 months apart, served as reference method. To evaluate the representativeness of the study population for the entire cohort, a comparison was made with the baseline questionnaire of a random sample of the cohort. RESULTS: Pearson correlation coefficients between nutrient intakes assessed by the record and the FFQ that was completed afterwards ranged from 0.40 (95% CI: 0.22-0.54) for vitamin B1 to 0.86 (95% CI: 0.80-0.90) for alcohol intake, with correlations for most nutrients between 0.6 and 0.8. Adjustment for energy intake and sex did not materially affect these correlations, except the correlation for fat intake, which changed from 0.72 to 0.52. Correlation coefficients were only slightly modified when the results were extrapolated to the cohort at large. Correction of correlation coefficients for attenuation by day-to-day variance in the record data improved them by 0.07 on average. CONCLUSIONS: It is concluded that the FFQ is able to rank subjects according to intake of food groups and nutrients. Despite a better performance of validation study participants, this conclusion also applies to the cohort at large.

Aged↗
PubMed1994

Agreement between interview data and a self-administered questionnaire on dietary supplement use.

OBJECTIVE: To study the relative validity of an open-ended question on the consumption of dietary supplements in the preceding five-year period, incorporated in a self-administered questionnaire used in the NLCS, The Netherlands Cohort Study on diet and cancer (120,852 men and women aged 55-69 years). DESIGN: Questionnaire data were compared with reference information from three personal interviews carried out within a period of 10 months. SETTING AND SUBJECTS: A randomly selected subgroup (59 men and 50 women) of the cohort living in 12 municipalities in the eastern and western regions of The Netherlands. RESULTS AND CONCLUSIONS: The overall sensitivity of the questionnaire concerning the use of any dietary supplement was 65.9%, the specificity was 98.5%; kappa as measure of agreement was estimated at 0.69. A high percentage recall was observed among women, users of at least three types of dietary supplements, long-term supplement users and those in the oldest age group. Recall of intake of specific supplements ranged from 77.8% for garlic preparations to 11.8% for 'other' supplements. Estimates of consumption of specific supplements (garlic and vitamin preparations) may provide enough precision to correctly classify individuals as users or non-users of those supplements.

Aged↗
PubMed1993

Public health problems and the rapid estimation of the size of the population at risk. Torsades de pointes and the use of terfenadine and astemizole in The Netherlands.

Recently, the use of astemizole and terfenadine, both non-sedating H1-antihistamines, caused considerable concern. Several case reports suggested an association of both drugs with an increased risk of torsades de pointes, a special form of ventricular tachycardia. The increased risk of both H1-antihistamines was associated with exposure to supratherapeutic doses; for terfenadine the risk was also associated with concomitant exposure to the cytochrome P-450 inhibitors ketoconazole, erythromycin and cimetidine. To predict the size of the population that runs the risk of developing this potentially fatal adverse reaction in the Netherlands, the prevalence of prescribing supratherapeutic doses and the concomitant exposure to terfenadine and cytochrome P-450 inhibitors was studied. Data were obtained from the PHARMO data base in 1990, a pharmacy-based record linkage system encompassing a catchment population of 300,000 individuals. The results of the study showed that the prescribing of supratherapeutic doses and the concomitant exposure to terfenadine and cytochrome P-450 inhibitors was low. Furthermore, the results of a sensitivity analysis showed that the risk of fatal torsades de pointes has to be as high as 1 in 10,000 to cause one death in the Netherlands in one year.

Adolescent↗
PubMed1993

A prospective cohort study on selenium status and the risk of lung cancer.

Selenium has been suggested to be anticarcinogenic and to play a role in the cellular defense against oxidative stress. The association between toenail selenium (a marker of long-term selenium status) and lung cancer was investigated in a cohort study of diet and cancer that started in 1986 among 120,852 Dutch men and women aged 55-69 years. After 3.3 years of follow-up, 550 incident cases of lung carcinoma were detected. Toenail selenium data were available for 370 lung cancer cases and 2459 members of a randomly selected subcohort. The rate ratio of lung cancer for subjects in the highest compared to the lowest quintile of toenail selenium, after controlling for age, gender, smoking, and education, was 0.50 (95% confidence interval, 0.30-0.81), with a significant inverse trend across quintiles (P = 0.006). The protective effect of selenium was concentrated in subjects with a relatively low dietary intake of beta-carotene or vitamin C. The rate ratio in the highest compared to the lowest quintile of selenium was 0.45 in the low beta-carotene group (95% confidence interval, 0.22-0.92; trend P = 0.028) and 0.36 in the low vitamin C group (95% confidence interval, 0.17-0.75; trend P < 0.001). The results of this study support an inverse association between selenium status and lung cancer and suggest a modification of the effect of selenium by the antioxidants beta-carotene and vitamin C.

Adenocarcinoma↗
PubMed1993

Cholecystectomy and colorectal cancer: evidence from a cohort study on diet and cancer.

The association between cholecystectomy and subsequent risk for colorectal carcinoma was investigated in a prospective cohort study on diet and cancer (n = 120,852), which is being conducted in the Netherlands from 1986 onwards among 120,852 men and women, aged 55 to 69. After a follow-up period of 3.3 years, 478 incident cases of colorectal cancer (258 men and 220 women) were identified in the cohort, 64 of whom reported at baseline to have undergone previous gall-bladder surgery (21 men and 43 women). After adjustment for age and familial history of large-bowel cancer, the relative rate (RR) for colorectal cancer in subjects who had undergone cholecystectomy compared with those who had not was 1.81 in men (p = 0.02) and 1.47 in women (p = 0.05). Additional adjustment for parity. Quetelet index, alcohol intake and other dietary variables resulted in a RR of 1.78 in men and 1.51 in women. In women, the highest RR was detected in the right colon (RR = 1.89), whereas in men, no site within the large bowel accounted specifically for the increased relative rate. In both men and women, the rate appeared to increase from approximately 6 years after cholecystectomy onward. According to the TNM stage of the disease, cholecystectomized patients were not detected at an earlier stage than the other patients. It is concluded that in this study the positive association between colorectal cancer and cholecystectomy cannot be explained by detection bias or ascertainment bias and is not confounded by risk factors for gallstone disease or dietary factors.

Aged↗
PubMed1993

A prospective cohort study on toenail selenium levels and risk of gastrointestinal cancer.

BACKGROUND: Various animal studies and ecologic studies suggest an inverse association between low dietary selenium intake and risk of various types of cancer. PURPOSE: The goal of this prospective cohort study was to investigate the association between toenail selenium levels and risks of stomach cancer and colorectal cancer. METHODS: Our cohort study on diet and cancer started in The Netherlands in 1986 with enrollment of 120,852 subjects aged 55-69 years. Of this number, 58,279 were men and 62,573 were women. Following the case-cohort approach for analysis of the data, we randomly selected from the cohort a subcohort of 3500 subjects (1688 men and 1812 women). After 3.3 years of follow-up, 155 incident cases of microscopically confirmed stomach cancer, 313 cases of colon cancer, and 166 cases of rectal cancer had been detected in the cohort. Toenail selenium data were available for 104 patients with stomach cancer, 234 with colon cancer, and 113 with rectal cancer and for 2459 subjects from the subcohort. RESULTS: In a multivariate analysis, the relative rates (RRs) of stomach cancer for subjects in increasing quintiles of toenail selenium level were 1.00, 0.44, 0.59, 0.84, and 0.64 (trend, P = .491). For men, there was some evidence for an inverse association between toenail selenium levels and stomach cancer: The RR for those in the highest compared with the lowest quintile of toenail selenium was 0.40 (95% confidence interval = 0.17-0.96), but the trend was not statistically significant (P = .136). For stomach cancer in women, there was no negative association with toenail selenium levels. Toenail selenium level was not associated with the risk of colon or rectal cancer. After exclusion of cases diagnosed in the 1st year of follow-up, the RRs of colon cancer for increasing quintiles of toenail selenium were 1.00, 1.27, 1.17, 0.75, and 1.07 (trend, P = .544); for rectal cancer, RR estimates were 1.00, 1.73, 0.83, 1.58, and 1.12 (trend, P = .890). CONCLUSIONS: These data support a suggestive but inconsistent inverse association between selenium levels and risk of stomach cancer. Our findings, like those of other studies, do not suggest an inverse association with risk of colorectal cancer.

Aged↗
PubMed1993

A prospective cohort study on dietary fat and the risk of postmenopausal breast cancer.

In 1986 a prospective cohort study on diet and cancer was started in the Netherlands among 62,573 women ages 55-69 years. Baseline information on diet and other risk factors was collected with a questionnaire. Cancer incidence was measured by record linkage with cancer registries and a pathology register. A case-cohort approach was used, in which the accumulated person time in the cohort was estimated by follow-up of a randomly selected subcohort (n = 1812). After 3.3 years of follow-up, 471 incident breast cancer cases were available for analysis. Questionnaire data for these cases and the 1716 female subcohort members without a history of cancer other than skin cancer were analyzed. In a multivariate analysis, controlling for traditional risk factors, the relative rates for breast cancer in increasing quintiles of energy-adjusted total fat intake were 1.00, 1.00, 1.34, 1.22, 1.08 (P-trend, 0.32). For saturated fat there was some evidence for a weak positive association when quintiles were used (relative rates in quintiles 1-5, 1.00, 1.22, 1.22, 1.38, 1.39; P-trend, 0.049). The 95% confidence interval (CI) for the top quintile was 0.94-2.06, however; and when saturated fat was used as a continuous variable, the effect was no longer significant (P = 0.20). Relative rate estimates for the highest versus lowest quintiles of monounsaturated fat, polyunsaturated fat, and cholesterol intake were 0.75 (95% CI, 0.50-1.12), 0.95 (95% CI, 0.64-1.40) and 1.09 (95% CI, 0.74-1.61), respectively, with no evidence for significant trends. This prospective study does not support a major role of dietary fat in the etiology of postmenopausal breast cancer.

Aged↗
PubMed1993

Garlic and its significance for the prevention of cancer in humans: a critical view.

Recently published results of epidemiologic case-control studies in China and Italy on gastric carcinoma in relation to diet suggest that consuming garlic may reduce the risk of gastric cancer. Chemical constituents of garlic have been tested for their inhibiting effect on carcinogenesis, using in vitro and in vivo models. In most experiments inhibition of tumour growth was established using fresh garlic extract, garlic compounds or synthetically prepared analogs. In this review the strengths and weaknesses of the experiments are discussed and the outcomes are evaluated to assess the possible significance of garlic or garlic compounds for the prevention of cancer in humans. It is concluded that evidence from laboratory experiments and epidemiologic studies is presently not conclusive as to the preventive activity of garlic. However, the available evidence warrants further research into the possible role of garlic in the prevention of cancer in humans.

Antineoplastic Agents↗
PubMed1993

Cancer mortality and residence near electricity transmission equipment: a retrospective cohort study.

Several studies in recent years have raised the possibility that exposure to extreme low frequency (ELF) electromagnetic fields may be hazardous to human health, in particular by the promotion or initiation of leukaemia and other cancers. To determine if this exposure creates a long-term hazard to the public, the mortality of a group of people identified as having lived in an urban quarter of Maastricht in which two 150 kiloVolt (kV) powerlines and one transformer substation are located was investigated. Using the Dutch population registry it was possible to identify retrospectively 3549 inhabitants of the quarter who lived there for at least 5 years between 1956 and 1981. Of these 1552 study subjects lived within 100 m of the electricity transmission equipment and were exposed to magnetic field intensity of 1.0-11.0 milliGauss. The overall standardized mortality ratio and cancer mortality ratios were either not or only slightly elevated. The study does not support previously reported associations of exposure to ELF electromagnetic fields with leukaemia, brain cancer and breast cancer.

Cause of Death↗
PubMed1993

The role of sexual factors in the aetiology of cervical dysplasia.

The effect of sexual behavior on the risk for cervical dysplasia was evaluated in a case-control study. Cases (n = 257) had a histologically confirmed diagnosis of cervical dysplasia. Controls (n = 705) were sampled from the general population. A postal questionnaire was used to obtain information about, among other things, age at first sexual intercourse, number of sexual partners, current frequency of intercourse and contraceptive use. Information was also collected about other risk factors for cervical dysplasia, in order to adjust for possible confounding. We observed higher risks for cervical dysplasia (mild, moderate and severe) with increasing number of sexual partners. This effect appeared to be dependent on smoking behaviour. For women who reported more than six sexual partners, the adjusted odds ratio (aOR) was 9.1 (95% CI: 3.5-23.7) for non-smokers, and 26.4 (95% CI: 11.8-58.8) for women who smoked > or = 20 cigarettes per day. The effects of age at first sexual intercourse and current frequency of intercourse disappeared after adjustment for other risk factors. Use of oral contraceptives for > 10 years increased the risk (aOR = 2.3; 95% CI: 1.2-4.6). Thus, the number of sexual partners, especially in combination with smoking behaviour, appeared to be the most important risk factor for cervical dysplasia.

Adjuvants, Immunologic↗
PubMed1993

The use of vitamins, minerals and other dietary supplements in The Netherlands.

By means of a two-day dietary record, information on the use of dietary supplements has been collected in 1987 and 1988 in a representative sample of the Dutch population aged 1-75 years. More than 17 percent of the population had been using at least one dietary supplement on at least one day of the survey. Age, sex, season, social class, alternative food habits, smoking and diet were related to the use of supplements. In young persons mainly fluoride and vitamin AD preparations were used, while a shift towards other supplements, like garlic and brewer's yeast preparations, was observed as age progresses. The use of single vitamin C supplements was not related to the level of mean daily vitamin C intake by food consumption.

Adolescent↗
PubMed1992

Why do elderly people seek professional home care? Methodologies compared.

In order to investigate which characteristics, besides physical limitations, of elderly people living at home contribute to the utilization of professional home care, a study was conducted in which 450 elderly people aged 55 and over, 123 with and 327 without professional home care, were interviewed. To obtain a selection for the interviews, a postal questionnaire, containing questions on functional status and care utilization, sent out to a random sample of the elderly people (55+) living at home (n = 2451), preceded the actual interviews. The oral interviews yielded the same information, plus an inventory of aspects of the mental status, the social network, the socio-economic status and the housing condition. Analysis was performed in three ways: bivariate analysis, logistic regression analysis and discriminant analysis. The bivariate analysis revealed that users of professional care were older, more often female and more often not married. Their social network was less extensive, as they received less informal care and lived alone more often. Besides they had more mental and financial problems. From the regression analysis it appeared that, in addition to the functional status, the amount of informal care and the household composition contributed to the utilization of professional home care. For the other characteristics inventoried, no independent association with the utilization of professional care could be established. With hindsight, it appeared that in this study long interviews hardly had additional value over postal questionnaires, in which the contribution of functional status and informal care to professional care was already discovered.

Aged↗
PubMed1992

Occupational epidemiological studies in risk assessment and their relation to animal experimental data.

The role of epidemiological and animal experimental studies in the process of qualitative and quantitative risk assessment is discussed. So far little agreement exists between animal experimental data and epidemiological outcomes in the procedure of qualitative risk assessment. Several reasons for these discrepancies are mentioned. The application of existing epidemiological study results in quantitative risk assessment is hampered by factors, such as the lack of exact exposure information (compound, level, duration), undefined other exposures in and outside the working environment, small sample sizes, the comparatively short duration of epidemiological studies and the absence of detailed information about the specific effects. All this resulted in a relatively small impact of epidemiological studies in risk assessment. Recommendations are made in order to improve the impact of epidemiology in risk assessment.

Animals↗
PubMed1992

Sources of interobserver variation in histopathological grading of cervical dysplasia.

The present study aimed to assess where the interobserver variation in grading cervical dysplasia stems from. Four experienced pathologists examined 93 histological slides, after they agreed on which morphological characteristics should be considered relevant for grading. They scored 6 morphological characteristics for each slide and assigned it to a degree of dysplasia. Compared to a previous study, the interobserver variation showed a statistically significant improvement: the weighted group kappa value increased from 0.55 to 0.69. For the scores of the individual characteristics considerable interobserver variation was observed: weighted group kappa values ranged from 0.28 to 0.49. The pathologists slightly differed in which characteristics they considered most important for their grading. The agreement on the degree of dysplasia turned out to be better than the agreement on the morphological characteristics on which this diagnosis is based. In the discussion, a few explanations for this paradoxical finding are put forward.

Confidence Intervals↗
PubMed1992

Mortality of workers exposed to acrylonitrile.

A retrospective cohort study was carried out in The Netherlands to investigate the potential carcinogenic effects in humans of occupational exposure to acrylonitrile (AN). The total study group consisted of 6803 workers "from eight chemical plants and one control plant" of whom 2842 had been exposed to AN between January 1, 1956 and July 1, 1979 for at least 6 months. All workers were employed by one of eight chemical companies. An extensive review of the available industrial hygiene data was conducted to assess the magnitude of past exposure to AN, occurrence of peak exposures, exposure to recognized potential human carcinogens, and respirator use. The total cohort was observed for mortality until January 1, 1988. In collaboration with the Central Bureau of Statistics, the causes of death were traced for the workers who died before 01-01-1988. In the exposed as well as in the nonexposed cohorts the total mortality was lower than expected, based on national mortality statistics. The observed cancer mortality in the exposed cohort was similar to the expected mortality. Specific analyses were carried out to investigate dose-response relationships and latency for total mortality and lung cancer mortality. Overall, no indications were found for a carcinogenic effect in this cohort of workers exposed to AN.

Acrylonitrile↗
PubMed1992

Cancer mortality among licensed herbicide applicators.

This retrospective cohort study investigated the cancer mortality of 1341 herbicide applicators licensed before 1 January 1980. The cohort was followed for mortality until 1 January 1988 by means of the Dutch system of population registers. For the subjects who died before 1 January 1988 the cause of death was obtained from the Central Bureau of Statistics. The cause of death was obtained for 98.4% of the deceased subjects. The total mortality was lower than expected according to mortality rates of the total male Dutch population. The total number of deaths from cancer was however slightly higher than expected [standardized mortality ratio (SMR) 114]. Mortality from several subtypes of cancer was also higher than expected, that for multiple myeloma being statistically significantly higher than unity (SMR 815, 95% confidence interval 164-2382). Occupational exposure to herbicides appears to increase the risk for multiple myeloma and possibly other malignant neoplasms.

Cohort Studies↗
PubMed1992

[The course of nursing home admission. A follow-up study in chronic and rehabilitation patients].

This article describes the course of the nursing home stays of 157 newly admitted patients (55 years and older) using the Behaviour Rating Scale for Elderly Patients ('Beoordelingsschaal Oudere Patiënten'). The follow-up period lasted maximally one year. Differences in the course in relation to the objective of the admission (rehabilitation versus continuous support) and possible factors which impeded or advanced the discharge of the rehabilitation patients, were investigated. For that purpose, information on diagnoses, prognosis, treatment goals and their achievement, and disability according to SIVIS (SIG Nursing Home Information System) was also obtained from the physicians in charge at the nursing home. The course of the nursing home stay appeared to differ for chronic and rehabilitation patients. In addition to physical disability and depressive behavior, the chronic patients, from the time of admission onwards, had more behavioural problems than the rehabilitation patients. Moreover, their dependency, physical and mental disability and inactivity increased in different degree during the stay. For two thirds of the rehabilitation patients, the stay did not end in discharge from the nursing home. For this group, the dependency, depressive behaviour, and to a lesser extent, aggressiveness increased during the stay. The outcome of rehabilitation appeared to be related to the extent of behavioural problems, to the level of disability, and to the medical condition on admission. The least disabled and the 'medically least complex' patients could usually be discharged with an improved level of functioning, which seemed to justify the nursing home stay. The absence of other services impeded discharge in a few cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗