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Biomedical subjects

M Berwick

Publications and source records attributed to M Berwick.

60 records · Page 4Linked to original sources
PubMed1990

Complete follow-up and evaluation of a skin cancer screening in Connecticut.

On May 21, 1988, 251 persons were screened for skin cancer in New Haven, Connecticut. A total body skin examination was performed on 98% of the participants. On the basis of follow-up of 93% of persons with positive screens for basal cell carcinoma, squamous cell carcinoma, or Bowen's disease, positive predictive values were 43% for basal cell carcinoma, 14% for squamous cell carcinoma, and 50% for Bowen's disease. In the group with atypical nevi, a person with two or more clinically atypical nevi was 16 times more likely to have histologic confirmation than a person with a single clinically atypical nevus (p = 0.003). Eighty persons were screened by both a dermatologist and a dermatology nurse; the crude agreement rate for actinic keratoses was 0.62; for atypical nevi, 0.53; and for BCC, 0.88. Both nurses and physicians overdiagnosed in the screening setting, the nurses more so than the physicians. Of the 128 persons screened who were advised to seek medical follow-up, 16 did not do so despite several reminders; their reasons are discussed.

Adolescent↗
PubMed1986

Assessment of exposure to indoor air contaminants from combustion sources: methodology and application.

A methodology for assessing indoor air pollutant exposures is presented, with specific application to unvented combustion by-products. This paper describes the method as applied to a study of acute respiratory illness associated with the use of unvented kerosene space heaters in 333 residences in the New Haven, Connecticut, area from September 1982 to April 1983. The protocol serves as a prototype for a nested design of exposure assessment which could be applied to large-scale field studies of indoor air contaminant levels. Questionnaires, secondary records, and several methods of air monitoring offer a reliable method of estimating environmental exposures for assessing associations with health effects at a reasonable cost. Indoor to outdoor ratios of NO2 concentrations were found to be 0.58 +/- 0.31 for residences without known sources of NO2. Levels of NO2 were found to be comparable for homes with a kerosene heater only and those with a gas cooking stove only. Homes with a kerosene heater and a gas stove had average two-week NO2 levels approximately double those with only one source. Presence of tobacco smokers had a small but significant impact on indoor NO2 levels. Two-week average levels of indoor NO2 were found to be excellent predictors of total personal NO2 exposure for a small sample of adults. Residences with kerosene space heaters had SO2 levels corresponding to the number of hours of heater use and the sulfur content of the fuel. Formaldehyde levels were found to be low and not related to unvented combustion sources. NO2, SO2, and CO2 levels measured in some of the residences were found to exceed those levels specified in current national health standards.

Air Pollutants↗
PubMedDate not supplied

Chemoprevention of aerodigestive cancer.

Effective chemoprevention of aerodigestive tumors could have far-reaching effects. Aerodigestive cancer accounts for one-third of all cancer deaths in the United States and is the most common cancer in some areas of the world. Prognosis is poor, and a reduced quality of life remains in those who do survive. To date, there have been no effective chemopreventive agents, but many new compounds hold promise. The concepts of field carcinogenesis and multi step carcinogenesis underpin the development of chemopreventive agents for aerodigestive tract tumors. Important risk factors are tobacco use, alcohol consumption, dietary habits, genetic susceptibility, socioeconomic status, and the interaction of these. Two promising areas for surrogate biomarker development are tissue autofluorescence and DNA repair. Numerous chemoprevention trials have shown that antioxidant compounds are effective in reversing precursor lesions. Studies of the effects of chemopreventive agents on second primary tumors are ongoing. Finally, large-scale trials of the anti-oxidant beta carotene have been disappointing; they have shown that among heavy smokers and possibly heavy alcohol consumers beta carotene increases risk for lung cancer incidence and mortality. These findings underline the critical need to better understand specific mechanisms of action at a particular tissue site, and under various conditions, such as heavy smoking. Novel agents are under development: epigallacatchin gallate, or green tea, curcumin, and a new emphasis on folic acid. Studies to date show that targeting susceptible subgroups, by means of genetic or lifestyle factors, and all ethnic groups will facilitate the goals of chemoprevention studies.

Anticarcinogenic Agents↗
PubMedDate not supplied

Gene-environment interaction in melanoma.

Gene-environment interaction can be defined as a different effect of an environmental exposure in people with different genotypes, or a different effect of a genotype in people with different histories of environmental exposure. Interaction applies when one stratum (high risk) responds differently to an exposure (sun) than another stratum (low risk). Genetic predisposition would appear to be a very important modifier of risk. This paper discusses the concept of gene-environment interaction applied to cutaneous melanoma through discussion of highly penetrant genes and their interaction with sun exposure, through discussion of low penetrant genes and their interaction with sun exposure, and by suggesting a new model for investigation of gene-environment interaction in melanoma. It is stressed that this area of investigation is extremely early in its development.

Cell Cycle↗