[Breast cancer in southeast Noord Brabant and in Noord Limburg; incidence and advancement of the diagnosis in a non-screened female population, 1975-1986].
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Breast Neoplasms↗
Biomedical subjects
P G Peer
Publications and source records attributed to P G Peer.
Cervical cancer survival in Nijmegen region, The Netherlands, 1970-1985.
Survival rates were computed for 359 women diagnosed with invasive cervical cancer between 1970 and 1985. The 5-year survival rate for the entire group was 67%. Survival was better in the period 1976-1980. Extension of the tumor and age at diagnosis were important prognostic factors. The effects of clinical stage, age at diagnosis, and year of diagnosis were studied simultaneously with the proportional hazards model. The hazard rate increased with increasing age and increasing clinical stage. Year of diagnosis had effect on survival only in case of IIB tumors. For the other clinical stages there was no significant effect on survival of year of diagnosis.
Adult↗
The effectiveness of cervical screening: a population-based case-control study.
The cervical smear histories of 36 women with invasive cervical cancer were compared to those of 120 age-matched controls, drawn from local registrar's offices. Of the cases 47% were screened at least once, while for the controls this figure was 68%. The relative risk of getting invasive cervical cancer for women screened at least once compared to women who were never screened was 0.32. The most important confounding factor was age at first intercourse. Contrary to other studies however, it was found that women who were younger when having first intercourse were screened more often. After correcting the relative risk of screened vs unscreened for age at first intercourse, the relative risk became 0.22. When the length of the interval since the last smear was considered, the relative risk was 0.18 when the smear was made between 2 and 5 years earlier and 0.30 when this smear was made more than 5 years earlier. These results support the assumption that screening is effective in the prevention of invasive cancer of the uterine cervix. Even a screening interval of more than 5 years provides considerable protection.
Adult↗
[Prevalence, case-finding and treatment of hypertension in Lelystad (1982-1984); is the 'rule of halves' still applicable?].
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Adult↗
Invasive bladder cancer. Should patients who respond to radiotherapy be treated by cystectomy?
A retrospective study was carried out on the long-term survival (5-12 years) of 160 patients with invasive transitional cell cancer of the bladder treated with irradiation between 1972 and 1980. Following 40 Gy irradiation of the lower abdomen, treatment consisted of cystectomy or continued irradiation of the bladder region only. A full urological examination of the bladder established whether a patient was a responder or non-responder. The patients were divided into four groups: 27 responders treated with cystectomy and diversion; 48 responders treated with continued radiotherapy up to 65 Gy; 24 non-responders treated with cystectomy and diversion; 42 non-responders treated with continued radiotherapy up to 65 Gy. Survival and complications of treatment were compared with regard to category and grade of the tumours and sex and age of the patients. It was concluded that the responders who underwent cystectomy after 40 Gy irradiation survived longer than those who received a full course of radiotherapy. The responders had a better survival rate than non-responders, regardless of further treatment. Salvage cystectomy was rarely carried out and proved to be an unsatisfactory alternative, with a high operative risk and short survival.
Aged↗
Twenty-five minutes between blood pressure readings: the influence on prevalence rates of isolated systolic hypertension.
The aim of the present study was to investigate the influence of a 25-min time interval between the first and the last reading of a series of six, on systolic (SBP) and Phase V diastolic (DBP) blood pressure and its implications for prevalence rates of hypertension. Readings were taken from 5999 persons (2889 men and 3110 women) by two observers using a Hawksley random-zero sphygmomanometer. The first reading was taken 5 min after entering the examining room. The study showed a considerable fall in mean SBP (men, 10.3 mmHg; women, 10.4 mmHg) and hardly a difference in mean DBP (men, 0.8 mmHg; women, 0.1 mmHg) between the first and sixth reading. The fall in SBP was independent of observer and sex and hardly correlated with age or Quetelet's index. The study also showed the implications for the classification of hypertension. Prevalence rates of isolated systolic hypertension dropped remarkably (men, 4.0 to 0.5%; women, 0.9 to 0.1%) between both readings while prevalence rates of severe, moderate and mild diastolic hypertension were nearly similar for the first and sixth reading.
Adult↗
Intra- or extrauterine transport? Comparison of neonatal outcomes using a logistic model.
In a retrospective study a comparative analysis of mortality by way of transport (maternal, neonatal, or not referred) was performed on 163 liveborn newborns with a gestational age of less than 32 wk or a birth weight of less than 1500 g. The occurrence of potential mortality risk factors in the subgroups was taken into account. Of these, caesarean section, sex, Apgar score, intubation after delivery, birth weight and gestational age showed a relationship with mortality. Logistic regression analysis regarding the relationship between mortality and way of transport revealed that mortality in the neonatal transport group was significantly higher than in the maternal transport group, taking into account the confounding risk factors sex, caesarean section, fetal growth retardation, birth weight and gestational age.
Apgar Score↗
Assessment of gestational age: a simplified scoring system.
Because of the disadvantages of the Dubowitz score in very ill preterms, an alternative score based on 7 morphological items was designed, and the results are compared to those of the Dubowitz score in 229 newborns. This scoring system proved to be reliable and easy to perform; standard deviation was +/- 10.2 days versus 9.7 days for the Dubowitz score.
Biometry↗
Effects of angiotensin II blockade in the canine puppy under different salt-intake.
The objective of this study was to investigate the relationship between the high activity of the renin-angiotensin-aldosterone system (RAAS) and the control of blood pressure and aldosterone in the canine puppy. The effect of the angiotensin II analog saralasin on arterial pressure (MAP), plasma renin activity (PRA), plasma renin concentration (PRC), and aldosterone (PA) was studied in unanesthetized normal, salt-loaded and salt-depleted puppies aged 9 to 30 days. Salt-loading was performed by daily intraperitoneal administration of 10 mEq sodium/kg body weight for 5 days and salt-depletion by furosemide injections. Saralasin infusion, 6 micrograms/kg/min, during 60 min significantly decreased MAP and increased PRC not only in salt-depleted puppies, as has been observed in adult salt-depleted dogs, but also in normal puppies (mean fall, 6.6 mm Hg). Although any developmental changes in the RAAS and MAP and in their relationship could not be ascertained, the fall in MAP during saralasin in normal puppies was significantly correlated to presaralasin renin values (r = 0.76, P less than 0.01, N = 11). PA did not change in both groups of puppies. In salt-loaded puppies saralasin caused no change of MAP, PRC, and PA. We conclude that the high renin levels at young age contribute to the basal arterial pressure in puppies.
Aldosterone↗
[Noninvasive blood pressure determination in newborn infants].
In 69 newborns (birth weight 900-3820 grams; gestational age 27-41 weeks) the Dinamap device was used to establish normative values for systolic and diastolic blood pressure, mean arterial pressure and pulse pressure for this indirect, non-invasive blood pressure monitoring system. Reference values for the first day after delivery in different birth weight groups are given and the changes during the first three days of life are shown. Blood pressure variability as a possible additional parameter in neonatal monitoring was found to be independent of birth weight and gestational age.
Birth Weight↗
Postnatal growth and differentiation of muscle fibres in the mouse. I. A histochemical and morphometrical investigation of normal muscle.
A histochemical classification of muscle fibres based on three enzymes (ATPase, pre-inc. pH 4:35; succinic dehydrogenase and alpha-glycerol-phosphate-dehydrogenase) was used to describe postnatal growth and differentiation of muscle fibres. The m. soleus, m. plantaris and m. gastrocnemius were examined in normal mice from birth to the young adult stage. At birth, differentiation of the gastrocnemius muscle was in a more advanced stage than that of the plantaris and the soleus muscles, while the last of these was the least developed. During growth, as well as in the (young) adult, there was a distinct relation between fibre type and size, which, however, differed per muscle (region). The development of muscle fibres was a gradual process, rather than a succession of distinct stages, although a change in fibre type was often accompanied by a change in size. Differentiation of fibres already occurred perinatally, and the "adult fast' fibre types appeared during the second week postnatally, varying with the muscle region. During development, a percentage of fibres remained as a population that was histochemically and morphometrically intermediate between the fast-oxidative-glycolytic and fast-glycolytic adult fibres. A model is presented in which the most probable pathways of development are depicted.
Adenosine Triphosphatases↗
Postnatal growth and differentiation of muscle fibres in the mouse. II. A histochemical and morphometrical investigation of dystrophic muscle.
Postnatal development of three hind legs muscles, the soleus, plantaris, and gastrocnemius, of dystrophic mice (ReJ 129) was investigated with histochemical and morphometric methods. The results were compared with normal postnatal development. Especially during the second week postnatally, there was severe fibre necrosis with no apparent preference for any particular fibre type. This period of necrosis was shortly followed by a wave or regeneration during the third week that could not, however, compensate for the loss of fibres. In dystrophic animals of 4-5 months of age, the number of fibres was reduced by 40-70%. Cross sectional areas of dystrophic muscles rarely, if ever, exceeded values for normal animals 14 days of age, while body weights were also drastically reduced. Growth and differentiation of the nonaffected fibres proceeded almost normally during the first month. During the second month, the "slow' fibres in the soleus muscle, and the "fast-oxidative-glycolytic' fibres in the plantaris muscle were hypertrophied, while, incidentally, some "fast-glycolytic' fibres showed hypertrophy; but in this case the average size of the fibre type was not increased. After two months, a general fibre atrophy was observed. The fate of the regenerated fibres was difficult to trace, especially in muscles older than one month. It is assumed that a number of them were capable of developing into "adult' fibre types histochemically. During the course of the disease the percentage of "intermediate' fibres increased markedly, whereas nearly all "fast-glycolytic' fibres disappeared. Because of these shifts in fibre profiles, the plantaris and the gastrocnemius muscles obtained a rather "juvenile' and "oxidative' aspect. Changes in the histochemical character of the soleus muscle were less spectacular. In dystrophic muscles, no new fibre types were found, compared with normal muscles. Rather, fibre types were present at the wrong moment, or occurred in quantities unusual for the age concerned.
Animals↗
Doppler flow characteristics in the main pulmonary artery and the LA/Ao ratio before and after ductal closure in healthy newborns.
Echo-Doppler (ED) techniques were used to estimate the time of closure of the ductus arteriosus in 30 normal neonates. We found that after birth there was a left-to-right (L-R) shunt through the ductus, which disappeared within 14 hours in 50% of the neonates investigated. Furthermore, patency of the ductus was not associated with a murmur. After closure of the ductus there was a significant diminution of the echocardiographically determined left atrium/aortic (LA/Ao) ratio, which was used as a measure of the L-R shunt.
Blood Circulation↗
Contacts in maximal occlusion.
Occlusion, defined as the presence of contact of antagonistic teeth, has been measured. This has been done by measuring the amount and magnitude of holes in bite registration materials taken from nine persons with complete natural dentitions. In spite of clear differences between the bites found by inspection, small differences have been found by measurement. Bite-, day- and testee-effects were controlled. The implications of the findings are discussed in terms of reliability and also of the epidemiological and clinical applicability of the method.
Adult↗
Reciprocal amino acid substitutions in the evolution of homologous peptides.
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Amino Acid Sequence↗
A review on family history of breast cancer: screening and counseling proposals for women with familial (non-hereditary) breast cancer.
With the aim to specify screening recommendations for women with familial (non-hereditary) breast cancer (FBC) we analysed 59 studies using quantitative methods of pooling. The pooled relative risk (RR) and cumulative probability were used to estimate breast cancer risk. The RRs for women with a family history of breast cancer in a first-degree relative was 2.03 (95% CI 1.09-2.22). The highest RR is observed for women with a family history and atypical hyperplasia in their breast biopsy specimen (RR = 10.87, 95% CI 6.05-19.69). A high cumulative probability before the age of 50 was only found for women with a combination of two risk factors: a family history and atypical hyperplasia, namely 19% (95% CI 11-33%). The cumulative probabilities of women aged 50 to 70 years who have a family history were between 11% (95% CI 9-13%, a family history in combination with age at first birth before 22 years) and 53% (95% CI 35-75%, a family history in combination with atypical hyperplasia). These high risks suggest that women over 50 years of age who have a family history of FBC have to be actively encouraged to participate in a screening program consisting of a biannual palpation by a specialist, an annual mammogram and a monthly self-control. Yearly screening is recommended for women under 50 years of age who have a family history and atypical hyperplasia. These recommendations remain valid until the effectiveness of such screening programs is assessed.
Aged↗