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Biomedical subjects

M Zielezny

Publications and source records attributed to M Zielezny.

At least 37 records · Page 2Linked to original sources

Nutritional epidemiology of postmenopausal breast cancer in western New York.

The authors studied 439 postmenopausal breast cancer cases, identified in hospitals throughout western New York, with an interview schedule that considered frequency and amount ingested of 172 foods and provided data for an estimate of total calories ingested. These were compared with age-matched controls comprising a random sample of the same communities as the cases. The extensive interviews, requiring 2.0 hours on average to administer, also covered alcohol ingestion, Quetelet index, and a wide variety of reproductive factors. The authors found, as have most investigators over the past 25 years, that risk increased with increases in age at first pregnancy, decreased with increases in numbers of children and pregnancies, and increased in those with history of benign breast disease and in those with female relatives previously affected with breast cancer. Risk adjusted for potential confounders was highest among women with the lowest ingestion of carotene or a substance correlated with its ingestion. Risk was not associated with retinol ingestion. It increased with increases in Quetelet index. Fat intake, whether studied in terms of quantity or the proportion of total calories derived from fat, was not associated with risk of breast cancer. Our analyses of these factors were adjusted for age, education, and the reproductive history traits described above.

Adult↗

Effects of metyrapone and dexamethasone upon pro-gamma-MSH plasma levels in depressed patients and healthy controls.

There is current controversy over the mechanisms underlying hypothalamic-pituitary-adrenal (HPA) axis hyperactivity in depression. Pro-gamma-melanocyte-stimulating hormone (MSH), a portion of the N-terminal region of pro-opiomelanocortin, has been shown to act synergistically with adrenocorticotropic hormone (ACTH) in stimulating corticosteroid secretion both in vitro and in vivo. Pro-gamma-MSH and ACTH plasma levels were measured in 30 drug-free male patients with a DSM-IIIR major depressive disorder and 21 healthy controls. The baseline levels were similar in the two groups. After single-dose metyrapone stimulation, both hormones increased, but pro-gamma-MSH was significantly higher in control subjects than in depressives. After overnight 1-mg dexamethasone, ACTH was significantly less suppressed in depressives than controls. These results suggest that HPA axis dysregulation in depression may involve peptides other than ACTH and be more complex than previously reported.

Adrenocorticotropic Hormone↗

Diet in the epidemiology of gastric cancer.

We examined the nutritional epidemiology of gastric cancer in 293 cases and neighborhood-, age-, and sex-matched controls in communities throughout the counties of Niagara, Monroe, and Erie in western New York. The interview was highly detailed, requiring two and one-half hours to complete; it attempted to provide an estimate of total calories ingested as well as of macro- and micronutrients and behaviors that could affect alimentary exposures, such as the use of refrigeration. We found that risk was enhanced by sodium, fat, and retinol. Substantial reductions in risk were associated with ingestion of carotene, especially raw vegetables (including celery, cucumbers, carrots, green peppers, tomatoes, and onions), as well as with increased use of low-temperature food storage. Both refrigeration and carotene could inhibit oxidation products that could act as carcinogens in the stomach.

Adult↗

Nutritional epidemiology of cancer of the esophagus.

This study of 178 cases of cancer of the esophagus from three counties in western New York, as compared with sex- and age-matched neighborhood controls in 1975-1986, replicated some earlier findings, particularly with regard to the increased risks associated with use of cigarettes and alcohol. The concentration of alcohol in an alcoholic beverage apparently did not affect risk: Beer carried a substantial risk, whereas less-dilute forms of alcohol carried no risk. These findings also suggest that the risk of cancer of the esophagus increases with ingestion of foods containing retinol but not carotene. Although increased risks were found to be associated with increases in total calories and fat ingested, as well as calcium, they appeared to be confounded with the risk associated with retinol, as distinct from carotene. Inasmuch as a difference in risk associated with retinol and carotene has been shown in a few previous inquiries dealing with esophageal cancer and cancer at other sites, a need for further investigations distinguishing risks associated with the two compounds is apparent.

Beer↗

Ambient 60-Hz magnetic flux density in an urban neighborhood.

A residential neighborhood in Buffalo, NY, was surveyed with a magnetic field meter to evaluate whether or not spot measurements are reliable predictors of the 60-Hz fields at street corners and residences. The results of repeated measurements over 7 days at 33 street corners in this neighborhood indicate that day-to-day variation in power line magnetic fields is negligible (intraclass correlation coefficient = 0.94). Multivariate linear regression analysis of the data indicates that transmission lines and thick, three-phase primary wires near the field measurement site are strong predictors and account for the majority of the ambient magnetic field variance between locations (multiple correlation coefficient squared = 0.60; F ratio = 22.2, P less than .001). Magnetic fields measured at the front sidewalk were highly correlated with fields at the front doorsteps of 45 homes in this neighborhood (gamma = 0.81). These results suggest that ambient power line magnetic field levels at urban residences can be reliably characterized on a one-time site inspection using a hand-held magnetic field meter and a simple wiring classification system.

Electric Power Supplies↗

The epidemiology of testicular cancer in upstate New York.

In a study of 250 cases of cancer of the testis and of neighborhood- and age-matched controls in upstate New York in 1977-1980, the authors found that risk was enhanced by possession of a number of traits associated with exposure of the testis to heat; occupational exposures to fertilizers, phenols, and fumes or smoke; and trauma to the testis. Risk was also increased for characteristics related to congenital and developmental aberrancies and testis-related abnormalities, e.g., low sperm count, fertility problems, atrophic testis, and cryptorchidism. Several of these risk factors were statistically significant in a multiple regression model that adjusted for all other significant traits, age, and education.

Adolescent↗

A survey of drug prescribing practices of dentists.

A survey of drug prescribing habits of 357 dentists practicing in five counties in Western New York was conducted in 1986. Respondents represented both general practitioners and specialists who were graduates of 25 different dental schools. From this study it can be concluded that dentists prescribe a wide range of drugs representing over 13 drug categories. The most frequently prescribed drug categories were antibiotics, narcotic analgesics, non-steroidal inflammatory agents, non-narcotic analgesics, and fluorides. The most frequent prescribers of drugs were oral surgeons, endodontists and periodontists.

Dentists↗

Obsessive-compulsive symptoms in agoraphobia: changes with treatment.

Ten patients suffering from agoraphobia with panic attacks reported significantly more obsessive-compulsive symptoms on the Comprehensive Psychopathological Rating Scale and Marks' Compulsion Checklist than healthy control subjects matched to the patients on sociodemographic variables. Behavioral treatment directed toward agoraphobia was associated with significant improvement in obsessive-compulsive complaints. On retesting, there were no significant differences in such symptoms between patients and controls. The results should alert the physician to inquire about the presence of agoraphobia in patients complaining of obsessive-compulsive disturbances.

Adult↗

Fibrin seal adhesive versus nonabsorbable microsuture in peripheral nerve repair.

Although nonabsorbable microsuture is the material most often used in human peripheral nerve repair, it is capable of eliciting a foreign body reaction, impairing vascularity, and potentially disrupting axonal regeneration. Sutureless methods, including fibrin seal adhesive, may offer an alternative to traditional suture techniques. This study compared the efficacy of fibrin seal with nylon microsuture in tibial microneurorrhaphy on 28 adult New Zealand white rabbits (14 with 10-0 monofilament nylon suture and 14 with fibrin seal). Each rabbit was reexplored at 1, 6, 12, and 18 weeks. The criteria used to compare the two methods were operative time, clinical function, electrophysiologic measures, and histologic findings. Fibrin seal repairs required less time to execute (p less than 0.01) but were inferior in mean conduction amplitude (p less than 0.01) and with respect to histologic criteria. Fibrin seal also appeared less effective in maintaining nerve approximation. We do not believe that fibrin seal provides a superior alternative to nonabsorbable suture in primary nerve repair in this experimental model.

Animals↗

Dietary epidemiology of cancer of the colon in western New York.

The authors interviewed 428 pathologically confirmed cases of colon cancer and controls matched on age, sex, race, and neighborhood in the New York counties containing the cities of Buffalo, Niagara Falls, and Rochester. Risk of colon cancer in both males and females, studied separately, appeared to increase with the amount of total fats and total calories ingested. In addition, we found the risk to increase with increases in the Quetelet index of relative weight (weight (kg)/height (m)2). Dietary fiber was only equivocally associated with risk. Fats and Quetelet index were associated with increased risk in a regression analysis adjusting each factor for the other, as well as for fiber, age, and socioeconomic status. The same was true for calories and Quetelet index. Future efforts to clarify a possible protective role for fiber and to disentangle the effects of fats and calories need to be undertaken. The fact that calories ingested and obesity are each associated with increased risk suggests the importance of studying calorie expenditure.

Body Height↗

The reliability of dietary history from the distant past.

A major barrier to the conduct and interpretation of retrospective studies of diet and cancer has been uncertainty about the reliability of retrospective measures of diet from the distant past. The authors therefore conducted a study to assess the reliability of retrospective dietary reports and to determine whether the retrospective report or the report of current diet is the better indicator of past diet. Persons (n = 323) originally interviewed regarding their diets in 1975-1979 were retrospectively reinterviewed in 1984-1985. There was little difference between the retrospective reports and the reports of current diet when group means were examined as indicators of past diet. The retrospective reports tended to overestimate the past frequency of consumption for most foods, whereas the reports of current diet tended to yield underestimates. Because food frequency-based dietary history data are more useful for ranking study subjects than for generating estimates of group means, correlation analysis was used as the principal assessment of the reliability of the two indicators of past diet. The retrospective reports more closely correlated with the diet reported at the original interview than did the report of current diet (for 37 of 47 foods). Nutrient indices based on the retrospective history were also more highly correlated with those of the original diet than were indices based on the current diet. No differences were noted in the reliability of retrospective reports according to age or sex. Subjects accurately reported perceptions of changes in their consumption of most foods, yet an estimate of past diet created by adjusting current diet for perceived change did not correlate more highly with the original diet than did the retrospective report. The authors conclude that assessing current diet to make inference about diet from the distant past does not yield more reliable estimates of past diet than does the retrospective dietary history. The best estimate of diet from several years in the past may be derived directly from a retrospective dietary history which focuses on that past period of time.

Aged↗

Measurement of subclinical changes during lithium prophylaxis: a longitudinal study.

Psychological distress was observer-rated with the Brief Psychiatric Rating Scale (BPRS) and self-rated with the Symptom Questionnaire (SQ) every other week for a 6-month period in 9 apparently remitted bipolar patients attending a lithium clinic. Substantial clinical fluctuations in psychopathology were observed with both rating methods. Compared to normal control subjects, patients suffering from bipolar disorder displayed significantly higher BPRS and SQ anxiety, somatization and total distress scores.

Adult↗

Health attitudes of psychiatric inpatients.

Despite the high prevalence of medical illness in the mentally ill population, little is known about the health attitudes of patients with combined medical and psychiatric disorders. We compared the health attitudes of a group of inpatients with concomitant medical and psychiatric illness, a group of physically healthy psychiatric inpatients, and a group of normals. The instrument used was the Illness Attitude Scales, a self-rating scale designed to explore beliefs which can be responsible for hypochondriacal attitudes. A self-rating scale of psychological distress, the Symptom Questionnaire, was administered as well. Compared to normals, psychiatric patients displayed more hypochondriasis. There were no significant differences in psychological distress or health attitudes between patients with concomitant physical and psychiatric disorder and physically healthy psychiatric patients.

Adjustment Disorders↗

Hostility and recovery from melancholia.

Twenty inpatients suffering from major depressive illness with melancholia were administered the hostility subscale of the Kellner Symptom Questionnaire and Paykel's Clinical Interview for Depression before and after treatment with amitriptyline. A matched control group of normal subjects had the same assessments at two points in time. Hostility decreased and friendliness increased in depressives after amitriptyline; upon recovery, there were no significant differences in hostility between depressed patients and control subjects, whereas such differences were striking during the illness. Patients who had reported losses before onset of illness rated themselves as more friendly than the other depressives; their hostility did not significantly decrease with recovery. The results suggest that hostility improves with the treatment of depression; life events appear to influence the degree of hostility in depressive illness as well as the response to treatment.

Adult↗

The effects of infant feeding on rotavirus-induced gastroenteritis: a prospective study.

The relationship between feeding method and risk of rotavirus infection was studied by following a cohort of 197 infants from low income households through the winter diarrhea season of 1983-84. Fecal specimens were systematically collected and tested for the presence of rotavirus particles by electron microscopy, confirmed by ELISA. The attack rates of rotavirus gastroenteritis were similar for breast-fed and bottle-fed infants (20 per cent, 17 per cent, respectively); however, the clinical course of rotavirus gastroenteritis was quite different. Infants who were breast-fed had illnesses which were characterized by milder symptoms of shorter duration. Of the 10 breast-fed infants who acquired rotavirus gastroenteritis, nine (90 per cent) were classified as mild illnesses while of the 25 bottle-fed infants who acquired rotavirus gastroenteritis, only nine (36 per cent) were classified as having mild illnesses. These data suggest that factors associated with breast-feeding, although not affecting rotavirus infection rates, may moderate the clinical course of rotavirus gastroenteritis.

Adolescent↗

The dexamethasone suppression and metyrapone tests in depression.

The dexamethasone suppression test (DST) and the metyrapone test (MT), a useful and reliable procedure for assessing the integrity of the hypothalamic-pituitary-adrenal (HPA) axis, were performed in 28 patients suffering from major depressive illness with melancholia. The relationship between the DST and MT appeared to be complex. Patients who failed to suppress cortisol secretion after dexamethasone administration had higher postmetyrapone cortexolone levels and cortexolone/cortisol ratios than suppressors. However, there was a wide range of metyrapone responses in patients exhibiting abnormal DST results. This suggests that failure of adequate suppression after 1 mg of dexamethasone in depressed patients does not necessarily reflect homogeneity in the HPA axis disturbances of such patients.

17-Hydroxycorticosteroids↗

Fluctuations in odds ratios due to variance differences in case-control studies.

If small effects of exposure on disease outcome are to be appropriately assessed, it is necessary to consider all potential sources of the fluctuation of relative odds. The authors consider the impact of differential variance in case and control exposure reports on the magnitude of the observed relative odds. With equal dispersion of case and control exposure, a difference in mean exposure generally produces a dose-response increase in relative odds. The combination of equal mean and unequal dispersion of case and control exposure produces a curvilinear pattern of relative odds. Greater mean exposure and dispersion of exposure among cases produce odds ratios lower than those that would be observed if dispersion among cases and controls were equal. Conversely, less dispersion among cases than among controls produces higher relative odds estimates. Differential error as a source of differential dispersion constitutes a potentially important source of bias.

Epidemiology↗