Biomedical subjects
Mark S Pearce
Publications and source records attributed to Mark S Pearce.
Stature of young people with malignant bone tumors.
BACKGROUND: Little is known about the aetiology of primary bone tumours. There have been conflicting reports relating to stature in young people with bone cancer. PATIENTS: We analysed height data at diagnosis for 364 patients with osteosarcoma and 356 patients with Ewing sarcoma registered on clinical trials run by the Medical Research Council (MRC) and the United Kingdom Children's Cancer Study Group (UKCCSG). MAIN OUTCOME MEASURES: Height at diagnosis for each patient was standardised for age and sex compared to national reference data with a standard deviation score (SDS) calculated for each subject. RESULTS: Those with osteosarcoma were significantly taller than the general population (mean height SDS 0.2, P=0.001). Patients with osteosarcoma of the femur were significantly taller than patients with other primary sites (mean height SDS 0.45 vs. -0.06, P=0.0001). Overall those with Ewing sarcoma were not significantly taller than the general population (mean height SDS 0.09, P=0.1), but children presenting under 15 years were taller (SDS 0.2, P=0.004) whilst older patients were not (SDS -0.07, P=0.4). In both osteosarcoma and Ewing sarcoma the mean age at diagnosis for females was significantly younger than for males. CONCLUSIONS: This study suggests that tall stature and an earlier pubertal growth spurt may be important factors in the aetiology of both osteosarcoma and Ewing sarcoma.
Fathers' occupational contacts and risk of childhood leukemia and non-hodgkin lymphoma.
BACKGROUND: There is evidence to suggest that childhood leukemia and non-Hodgkin lymphoma have an infective etiology. We investigated the risk of childhood leukemia and non-Hodgkin lymphoma in relation to paternal occupational contact with other individuals, a surrogate for potential exposure to infection. METHODS: We carried out a case-control study using 792 cases from the Northern Region Young Persons' Malignant Disease Registry, United Kingdom, 1968-1997, and 2 large population-based control groups. Paternal occupations at birth were classified as having standard, high, or very high levels of contact. Conditional logistic regression was used in the analysis. RESULTS: There was an increased risk of childhood leukemia and non-Hodgkin lymphoma in those children whose fathers' occupational contacts were high or very high compared with standard (odds ratio = 1.3; 95% confidence interval = 1.0-1.5). The excess risk in the very high group was most pronounced for 245 cases of acute lymphoblastic leukemia aged 2 to 5 years at diagnosis (1.5; 1.1-2.1). The risk with paternal occupational contacts was greater in rural areas, although it was also present in urban areas. The risks of leukemia and non-Hodgkin lymphoma were also higher among the offspring of men employed as policemen, sales representatives, or teachers. CONCLUSIONS: Our findings are consistent with the hypothesis of an infective etiology for childhood leukemia and non-Hodgkin lymphoma, and they add to the evidence that infections could be transmitted to children by adults.
IgG subclass responses in childhood Helicobacter pylori duodenal ulcer: evidence of T-helper cell type 2 responses.
BACKGROUND: Duodenal ulcer in adults chronically infected with Helicobacter pylori is associated with a polarized T-helper cell type 1 (Th1) mucosal immune response, with a predominantly immunoglobulin G2 (IgG2) systemic specific response. It has been suggested that children colonized by H. pylori also produce a mucosal Th1 response, but there are few studies that have measured IgG subclass responses in children with duodenal ulcer. MATERIALS AND METHODS: Seven children with endoscopically proven duodenal ulcer and H. pylori infection and 18 children with biopsy proven H. pylori infection but no duodenal ulcer had relative concentrations of IgG subclass responses (IgGsc) against H. pylori antigens measured by ELISA. Eighteen IgG seropositive adults acted as controls. The range of antigens recognised by IgG1 and IgG2 subclass responses were investigated by Western blots. RESULTS: There were no differences in mean IgGsc responses between children with or without duodenal ulcer. Adults produced an IgG2 predominant response. Western blots showed no qualitative differences in antigens recognised by IgG1 or IgG2. CONCLUSION: Children with duodenal ulcer, in contrast to adults, produce an IgGsc response consistent with a mucosal Th2 response to H. pylori regardless of the presence of duodenal ulceration. This suggests that disease causation amongst children with H. pylori associated duodenal ulceration may not be dependant upon a mucosal Th1 biased response.
Life course measures of socioeconomic position and self reported health at age 50: prospective cohort study.
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Skin cancer in children and young adults: 28 years' experience from the Northern Region Young Person's Malignant Disease Registry, UK.
Little population-based data has been published about skin cancers in children and young adults. In this study, 200 cases of melanoma and non-melanoma skin cancers diagnosed under 25 years of age in the North of England from 1968-1995 were obtained from the Northern Region Young Persons' Malignant Disease Registry. The incidence was 1.2 cases per million per year for children (aged 0-14 years) and was 13 cases per million per year for young adults (aged 15-24 years). Melanoma accounted for 138 cases, of which 16 were in subjects aged < 15 years at diagnosis. The incidence of melanoma increased in females at a rate of 5.6 per million per decade (95% confidence interval [CI] 2.2-8.9, P = 0.002), largely due to an increased incidence of primary lower limb tumours. The incidence for males was unchanged. Survival improved significantly over time for both males and females (P < or = 0.02). Of the 62 patients with non-melanoma skin cancers, 66% were diagnosed with primary non-basal cell carcinoma, 13% with dermatofibrosarcoma protuberans, 10% with squamous cell carcinoma and 11% with other tumours. Two cases were iatrogenic second malignancies following treatment for an earlier primary brain tumour. The incidence of non-melanoma skin cancers was significantly higher during 1982-1995 than during 1968-1981 (rate ratio 1.7, 95% CI 1.0-2.8). There were three deaths from non-melanoma skin cancer, and the overall 5 year survival rate was 98% (95% CI 89-100%). The reason for the increasing incidence of both melanoma and non-melanoma skin cancer in young people is unknown, but it is likely that ultraviolet exposure plays an aetiological role. It is important that families continue to be advised of the need for vigilance with regard to childhood sun exposure.
The influence of age and gender on the relationship between birth weight and blood pressure in childhood: a study using 24-hour and casual blood pressure.
UNLABELLED: This study investigates the influence of age and gender on the relationship between birth weight and blood pressure in childhood, using casual and 24-h blood pressure measurements. Casual and 24-h blood pressure were measured on 976 normal schoolchildren (550 girls) aged 6 to 16 years. There was no significant association between birth weight and casual systolic blood pressure (regression coefficient (ss)=-0.30; 95% CI -1.79, 1.19). There was a significant negative correlation between birth weight and mean 24-h systolic blood pressure (ss=-2.13; 95% CI -3.35, -0.90). Subgroup analysis by gender revealed a significant relation for girls (ss=-2.88; 95% CI -4.44, -1.32) but not boys (ss= -1.02; 95% CI -2.99, 0.95). ). Subgroup analysis by age group revealed a significant relation for > or =11 years old (ss= -3.17, 95% CI -4.86, -1.48) but not children <11 years old (ss= -0.88; 95% CI -2.63, 0.88). Interaction tests demonstrated a statistically significant different relationship between birth weight and blood pressure for boys and girls ( P=0.021) and for children <11 and > or = 11 years of age ( P=0.036). CONCLUSION: this study demonstrates that gender and age have an important influence on the relationship between birth weight and blood pressure in childhood. The observed differences between boys and girls and the different age groups remain unexplained.
Life course determinants of insulin secretion and sensitivity at age 50 years: the Newcastle thousand families study.
BACKGROUND: Suboptimal nutrition during fetal life and infancy is suggested to increase insulin resistance in adulthood. This study investigated the proportion of variance in insulin secretion and resistance accounted for by factors operating at different stages of life using a cohort of all 1142 births in the city of Newcastle, UK in May and June 1947. METHODS: Detailed information was collected prospectively during childhood, including birth weight, growth and socio-economic circumstances. At age 50, 412 study members attended for clinical examination. Fasting and 30-min plasma insulin and glucose levels were determined and HOMA-IR and insulin secretion derived. RESULTS: Birth weight was not a significant predictor of HOMA-IR after adjustment for percent body-fat and waist-hip ratio. Duration of breastfeeding was significantly negatively associated with HOMA-IR in men. For both genders, fetal life explained directly little variation in either HOMA-IR or insulin secretion (0.1-5.6%). Compared to early life, adult lifestyle and body composition directly explained larger proportions of the variances for insulin secretion and HOMA-IR for men (11 and 22% respectively) and women (5.9 and 34%). CONCLUSIONS: Insulin secretion is largely unexplained by these data. For insulin resistance, the evidence suggests a limited impact of early life and a larger impact of adult factors.
Incidence and survival for testicular germ cell tumor in young males: a report from the Northern Region Young Person's Malignant Disease Registry, United Kingdom.
The incidence of testicular cancer has increased markedly in most developed countries, although the reasons for this are unclear. In this study, 253 patients with testicular cancer diagnosed younger than 25 years from 1968-1999 were identified from the Northern Region Young Persons' Malignant Disease Registry. The age-standardized incidence rate increased from 0.93 in 1968-1978 to 1.60 per 100,000 in 1990-1999. The increase in incidence was confined to those patients >15 years old, with the rate in younger children remaining very low. The 5-year survival increased significantly from 46% (95% confidence interval [CI] 33% to 58%) to 92% (95% CI 85% to 96%) during 1968-1999 and was significantly higher for seminoma than nonseminoma, 91% (95% CI 78% to 96%) and 77% (95% CI 70% to 82%), respectively. Although increased surveillance and public health campaigns designed to raise awareness of the disease and the advantages of self-examination should continue, further research is required into the etiology of this relatively common cancer among young males.