PubMed Health⌕ Search

Biomedical subjects

M Geddes

Publications and source records attributed to M Geddes.

At least 19 recordsLinked to original sources

Hematopoietic cell transplantation for Crohn's disease; is it time?

AIM: To review all studies in the literature that have assessed Hematopoietic cell transplantation (HCT) and Crohn's disease (CD) with the ultimate aims of determining if this is a viable treatment option for those with CD. A secondary aim was to review the above literature and determine if the studies shed further light on the mechanisms involved in the pathogenesis of CD. METHODS: An extensive Medline search was performed on all articles from 1970 to 2005 using the keywords; bone marrow transplant, stem cell, hematopoietic cell, Crohn's disease and inflammatory bowel disease. RESULTS: We identified one case in which a patient developed CD following an allogeneic HCT from a sibling suffering with CD. Evidence for transfer of the genetic predisposition to develop CD was also identified with report of a patient that developed severe CD following an allogeneic HCT. Following HCT it was found that the donor (that had no signs or symptoms of CD) and the recipient had several haplotype mismatches in HLA class III genes in the IBD3 locus including a polymorphism of NOD2/CARD15 that has been associated with CD. Thirty three published cases of patients with CD who underwent either autologous or allogeneic HCT were identified. At the time of publication 29 of these 33 patients were considered to be in remission. The median follow-up time was seven years, and twenty months for allogeneic and autologous HCT respectively. For patients who underwent HCT primarily for treatment of their CD there have been no mortalities related to transplant complications. CONCLUSION: Overall these preliminary data suggest that both allogeneic and autologous HCT may be effective in inducing remission in refractory CD. This supports the hypothesis that the hematolymphatic cells play a key role in CD and that resetting of the immune system may be a critical approach in the management or cure of CD.

Autoimmune Diseases↗

Effect of medroxyprogesterone pretreatment on pentagastrin-induced panic symptoms in females with panic disorder.

Clinical observation, as well as epidemiological and research data, suggest that female gonadal hormones influence the course of panic disorder (PD). Panicogenic agents such as pentagastrin are useful tools with which to study the pathophysiology of panic attacks. Nine women with PD were randomly assigned to receive, in a crossover design, a 3-day pretreatment with medroxyprogesterone acetate (MP) prior to an injection of pentagastrin, and a 3-day pretreatment with a placebo prior to another injection of pentagastrin. The panic response and the anxiety response to pentagastrin were decreased after MP pretreatment. These preliminary results support the use of laboratory models for investigations of the interactions between progestins and anxiety.

Adult↗

The use of complementary therapies by breast cancer patients attending conventional treatment.

The aim of this study was to measure the proportion and characteristics of complementary therapy (CT) users among female breast cancer patients receiving conventional treatment. 473 women who had received surgical intervention for breast cancer in the year of diagnosis were sent a questionnaire for completion, and 242 responded. CT had been used by 16.5% after cancer diagnosis, only 8.7% before. The most commonly used CTs were homeopathy, manual healing method, herbalism and acupuncture. The main reason for using CTs was physical distress. Only a minority was searching for psychological support. 24 users were satisfied with these treatments, and two-thirds would suggest them. Users were significantly younger, more educated, and previous users of CTs than non-users. Adjusting each variable for the effect of the others, only previous use had an independent effect on increasing the probability of being users after cancer diagnosis.

Acupuncture Therapy↗

Malignant melanoma in Europe: changes in mortality rates (1970-90) in European Community countries.

Reducing mortality, especially premature death, is a major goal of the fight against cancer. In this study, we have analyzed trends in malignant melanoma (MM) mortality in the European Community (EC) as a whole and for each country. The data (obtained from the World Health Organization data bank) have been analyzed for the period 1970-90, by age groups (20-44, 45-64, 65-74, 75+ years). Trends are presented as percentage change of mortality rate for each three-year period in comparison with the rate in the first one (1970-72). The mortality from MM in the EC as a whole increased for both genders (men, +89.2 percent; women, +72.6 percent), with statistically significant trends in all age classes. Northern countries experienced mortality changes about 30 to 50 percent less than the EC average increase. Greater changes were seen in southern European countries, in which recent standardized rates are near to those observed in northern European populations. Among Mediterranean people, the highest increase (more than fourfold) was observed in Spain. The significant increase found for the younger age class makes unlikely the risk of misclassification with other skin cancers. No future decrease in MM mortality in the EC is indicated from these data.

Adult↗

Survival of classic Kaposi's sarcoma and risk of second cancer.

In order to elucidate survival rates and risk of second primary cancer, we assessed 204 patients with histologically confirmed classic Kaposi's sarcoma (KS) who were identified in 11 Italian population-based cancer registries. One hundred and thirty-nine were men (median age 70 years) and 65 were women (median age 72). One, 5 and 10 year survival rates were 0.92, 0.69 and 0.46 respectively. Median survival was 9.4 years (i.e. not different from the Italian general population of the same sex and age). Survival did not vary according to sex and tumour site (i.e. lower limbs only or other). Eleven second primary cancers, including two lung and two kidney cancers, were reported after KS diagnosis (not different from the expected number).

Age Factors↗

Epidemiology of lung cancer.

Primary lung cancer is now the most frequent cancer in the world. Tobacco smoking still represents its predominant cause: a recent estimate attributes 80-85% of lung cancers to smoking and the epidemic of lung cancer mortality is still ongoing, with a major contribution from East European and developing countries. The study of smoking in association with lung cancer has contributed to the understanding of the carcinogenic process in humans, especially since molecular epidemiology techniques have been developed. However, the most probable carcinogenic model, still needs to be more clearly established. Presently, it can be summarised that smoking cessation is beneficial at any age, and more so when early. The contribution of passive smoking to lung cancer risk has been widely documented; its effect in terms of attributable number of cases, however, is not easily estimated at a population level. Some authors suggest that non-smoking-related lung cancer frequency is increasing over time. Exposure to environmental carcinogens with a major emphasis on those deriving from industrial processes, among which asbestos, and on air pollution due to traffic in urban areas has been advocated. Finally, a special interest has grown in the last years on possible protective factors for lung cancer, mainly diet-related (high intake of fresh fruits and vegetables), but results from the first large randomised chemoprevention trial based on alpha-tocopherol and beta-carotene treatment, dealt with "paradoxical" results.

Carcinogens, Environmental↗

[Gastrointestinal system tumors in Italian emigrants].

In this paper we present the risk of death for stomach, colon, rectum and pancreas cancers in Italian migrants to Canada, Argentina, Australia, France and England and Wales. Estimations of relative risks (RR) in Italian migrants, in residents in Italy and in Southern Italy relative to the local born in the host country are shown. Relative risks in Italian migrants to Australia were analysed also by duration of stay in the host country. The Italian migrants' cancer profile in intermediate between the origin and the host population: a reduction of risk of death for stomach cancer and an increase of risk for colorectal cancers are the main results. The results are discussed taking into account the analysis by duration of residence and the pattern of food prevalent in the different countries considered.

Adolescent↗

[Etiological epidemiology of colorectal tumors].

We reviewed the main results of colon cancer (CC) epidemiologic studies, according to data published in the 1973-1994 period, with a particular mention to dietary factors and to differences with Italian findings. Meat (mostly, red meat), animal fats and high energy intake not counterbalanced by sufficient physical activity seem to be the most consistent risk factors for CC. On the contrary, the vegetarian based diet seems to reduce the risk of CC. Although interestingly, the relevance to CC of other life-style and diet-related factors (alcohol intake, smoking habits, processing and cooking methods, occupation, drugs, personal medical and reproductive history) must be better defined and requests further investigations. More recently, genetic studies are clarifying the hereditary risk of CC. Several colon carcinogenesis hypotheses have been proposed, but general agreement on the most reliable is still lacking. Authors argue that in the next future, new acquirements could emerge from metabolic polymorphism studies, possibly reconciling the biological significance of individual susceptibility and environmental factors to CC incidence.

Alcohol Drinking↗

Cancer mortality in Italian migrants and their offspring in Canada.

Studies on the offspring of migrants provide important information on the contribution of environmental and genetic factors in the etiology of various cancers. The aim of the present study is to analyze the cancer risk in Italian-migrants (Canadian residents born in Italy) and their offspring compared with the host population. Odds ratios (OR) and 95 percent confidence intervals (CI) by site and birthplace categories (migrants, pure and mixed Italian-parentage Canadians) were calculated by means of a case-control study using the 'other cancer deaths' as controls and taking the host population as the reference category. The study shows that Italian migrants retain a significantly low risk for a series of cancers: colon (OR = 0.9 in males and 0.7 in females); lung (OR = 0.8 in males and 0.5 in females); and breast (OR = 0.9). For all of these sites, risks in the offspring of Italian migrants were not different from those of the host population, with some differences between the genders with respect to cancer of the colon. Stomach cancer presents a significantly high rate in migrants (OR = 1.9 in males and 2.4 in females), consistent with the population of Italy; in their offspring, risks are similar to those in the host population. The risk of cancer in the offspring of migrants is, for many sites, intermediate between the host population and the Canadian residents born in Italy. This finding possibly is related to the larger integration of the offspring than their parents in the cultural and social environment of the host population.

Adolescent↗

Population-based breast cancer survival. Mammographic screening activities in central Italy.

BACKGROUND: The aim of this study was to evaluate the effect on 5-year survival of patients with invasive breast cancer relative to demographic and clinical variables (age, residence, and disease diffusion) and to early diagnostic procedures performed in the area. METHODS: The observed (Kaplan-Meier method) and relative 5-year survival in 1263 patients with invasive breast cancer in the Province of Florence, Italy, between 1985-1986 (source: Tuscany Cancer Registry) are presented. The results were compared with those of other European areas and of the Surveillance, Epidemiology, and End Results Program. The Cox model is used to evaluate the effects of age at diagnosis (5-year age groups), disease diffusion (localized, regional, distant, unspecified), residence (Municipality of Florence, screening area, other municipalities), and source of diagnosis (Center for the Study and Prevention of Cancer, hospitals) on observed survival. RESULTS: Observed 5-year survival was 68.4% (Kaplan-Meier method) and relative 5-year survival was 75.4%. Relative survival for patients younger than age 35 at diagnosis was high (82.3%); it decreased slowly from 80.5% in the group of patients 35-44 years of age, to 74.0% in those 65-74 years of age, and steeply decreased to 68.1% in those 75 years of age and older. Relative 5-year survival in Florence was lower only than that observed in Switzerland (Geneva) and in the USA (whites). Five-year prognosis was worse in women 70 years of age or older, in advanced stages, in residents of municipalities not involved in the screening program, and in cases diagnosed in hospitals. The gain in survival may be explained partially by lead-time effect and by length bias due to early diagnosis both in self-referred women and in screening-detected cases. In these cases, though, the better prognosis, although attenuated, persisted after adjustment by disease diffusion. CONCLUSIONS: The results suggest that the early diagnosis of breast cancer in self-referred women affects prognosis, at least concerning 5-year survival. Moreover, although lead-time effect and length bias cannot be excluded in this study, screening by personal invitation may reduce the disadvantage in the survival of patients with breast cancer often observed in rural areas.

Adult↗

Cancer mortality in Italian migrants to Canada.

The present study reports on the analysis of cancer mortality in Italian first-generation migrants resident in Canada, deceased in the period between 1964-1985 (5,801 males: 3,267 females). Mortality in migrants is compared to that of the host population as well as to that in the migrants' country of origin. This is carried out both on a national level (Italy), and on a regional level with those regions that have made the greatest contribution to the Italian migratory flow (Southern Italy). Compared with the Canada-born population, significantly higher risks were evident for nasopharynx, stomach, liver and gallbladder tumors in migrants. Lower risks were observed for the oral cavity, esophagus, colon, rectum, pancreas (females), larynx, lung, melanoma, breast, ovary, prostate, bladder (females), and non-Hodgkin's lymphoma in migrants. This is consistent with that evidenced in the comparison between Italy and Canada. The data are discussed in relation to the results of other studies on Italian migrants and the prevalence of main risk factors.

Age Distribution↗

Kaposi's sarcoma in Italy before and after the AIDS epidemic.

The incidence of Kaposi's sarcoma (KS) in 1976-90 was assessed in Italy, taking advantage of a network of nine population-based cancer registries covering, at its maximum, approximately 5.6 million subjects. The first examined period (1976-84) substantially reflects the epidemiology of KS prior to the AIDS epidemic in the registration areas. Elevated incidence rates, standardised to the Italian population of 1981, of 1.05/100,000 men and 0.27/100,000 women emerged in 1976-84 (i.e. from two- to threefold higher than in the USA and Sweden, more than tenfold higher than in England and Wales). These high rates, especially remarkable in the Registry from the south of Italy (i.e. Ragusa, 3.01/100,000 men and 0.54/100,000 women) suggest that the prevalence of the still unknown causative agent for KS was high, at least in some parts of Italy, prior to the AIDS epidemic. In the most recent period (1985-90), an approximately twofold increase in KS incidence rates in Italian men below age 50 was observed (from 0.15 in 1976-84 to 0.47 in 1985-90). Conversely, declines in KS incidence were recorded in older men.

Acquired Immunodeficiency Syndrome↗

Progress in the fight against cancer in EC countries: changes in mortality rates, 1970-90.

The question of how much effective progress against cancer is being made has been raised repeatedly during the last decade; one approach to evaluating such progress is represented by the analysis of mortality, which has been used by several researchers. Here we report mortality trends for 1970-90 for four age-groups, calculated for each 3-year period, and presented as the percentage change of the rate of the first period examined. Detailed graphs for each country and for the European Community as a whole are presented for 'all cancers', and for cancer of the colon-rectum, lung, breast and ovary. For other cancers (stomach, melanoma, uterus, testis and Hodgkin's disease), the graphs are presented only for the whole of the European Community. Variations in mortality are discussed, in terms of changes in incidence, efficacy and diffusion of prevention, as well as improvement in diagnosis and treatment.

Adolescent↗