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Biomedical subjects

S Grufferman

Publications and source records attributed to S Grufferman.

At least 55 records · Page 3Linked to original sources
PubMed1985

Mortality among white and nonwhite farmers in North Carolina, 1976-1978.

Death certificate information identified 9,245 white and 3,508 nonwhite men who died in North Carolina during 1976-1978 and who had been farmers. The distribution of deaths from various causes among these men was compared to that of other male decedents in the state. For both white and nonwhite farmers, proportional mortality ratios (PMRs) were elevated for tuberculosis (whites, 1.6; nonwhites, 1.7), diseases of the skin and subcutaneous tissue (whites, 2.5; nonwhites, 1.5), and external causes (whites, 1.2; nonwhites, 1.1) and were decreased for cancers of the esophagus (whites and nonwhites, 0.5) and large intestine and rectum (whites and nonwhites, 0.7). White farmers had an increased relative frequency of melanoma (PMR = 1.2) and other skin cancer (PMR = 1.8), while nonwhite farmers had an increased relative frequency of melanoma (PMR = 6.3), brain cancer (PMR = 2.3), and leukemia (PMR = 1.9). In addition, among decedents under 65 years of age, both white and nonwhite farmers had an elevated proportional mortality ratio for prostate cancer (whites, 1.6; nonwhites, 1.3). Many of these results are consistent with observations from other studies. Some of these findings, particularly those for nonwhites, warrant further evaluation, including detailed investigation of possibly related farming practices.

Aged↗
PubMed1985

Impact of medical school class ranking systems on applicants' ratings for residency positions.

The systems used by the medical schools for evaluation of 106 applicants for 1984-85 pediatric level 1 (PL-1) residency positions at the Duke University Medical Center were studied by the authors to determine the possible relationship between contents of the applications and the rankings of these applicants for the National Resident Matching Program (NRMP). In the 56 U.S. medical schools studied, the grading systems of 24 medical schools used three passing grades (usually A, B, C), 14 used two passing grades (usually honors and pass), six used one passing grade (pass) and seven used a mixed system or number grades. The grading systems of five schools could not be discerned. Ten schools provided the class distribution of the awarded grades, and 23 identified the relative class standing of the applicant. Twenty-seven schools disclosed the position of the applicant in the class through grade distribution data or class standing; the 29 other schools did not make such information known. Students whose schools had identified their class positions achieved higher rankings from the residency selection committee than did students from schools which did not, in spite of the fact that schools which did not disclose the student's comparative positions were categorized as being more "distinguished."

Educational Measurement↗
PubMed1985

Socioeconomic status and risk of multiple myeloma.

A case control study was conducted to test the hypothesis that socioeconomic status is positively associated with multiple myeloma incidence. One hundred and fifty-three myeloma cases and 459 controls were identified at the Duke University Medical Center at Durham, North Carolina. Study members were interviewed regarding indicators of socioeconomic status. The association of myeloma with family income (current and highest), education, occupation, home ownership, dwelling size, and an index of crowding in the home was examined by estimating relative risks. Among these indicators, only home ownership showed any association with multiple myeloma incidence (RR = 1.6, 95% CI: 1.0-2.6). The association of multiple myeloma with socioeconomic status that has been seen in earlier studies may have been due to underascertainment of disease in less advantaged groups. This association is disappearing as access to health care becomes more uniform across socioeconomic groups.

Aged↗
PubMed1984

Climate, socioeconomic status and Hodgkin's disease mortality in the United States.

This study examines the relative effects of climate and socioeconomic status (SES) on standard mortality ratios (SMR) from both young adult and older adult Hodgkin's disease (HD) in the United States. Climate variables explain a greater percentage of the variation in the SMR for HD than do SES variables. After adjusting for SES, indicators of climate exhibit a strong correlation with the young adult SMR, but not with the older adult SMR. These findings suggest that environmental factors play an important role in the etiology of young adult HD and support the hypothesis that young adult HD is a different disease from the older adult form.

Adult↗
PubMed1984

Epidemiology of Hodgkin's disease.

Hodgkin's disease displays an intriguing variation in incidence with age. For adult disease, there is striking bimodality in incidence with peaks in young adulthood and in older adulthood. On epidemiologic grounds, there appear to be three different diseases: childhood (0-14 years), young adult (15-34 years), and older adult Hodgkin's disease (55+ years). There are marked geographic variations in Hodgkin's disease incidence, but the variations are different for the three age groups. There are also interesting associations between Hodgkin's disease and markers of social class. For the young adult disease, the higher the socioeconomic status of a person, the greater the Hodgkin's disease risk. Additionally, Hodgkin's disease patients appear to have had fewer of the childhood infectious diseases or to have had these diseases at older ages than controls. These factors suggest an analogy between young adult Hodgkin's disease and Epstein-Barr virus, poliomyelitis, and tuberculosis infections. Thus, the descriptive epidemiology of Hodgkin's disease suggests an infectious disease process underlying its etiology in young adulthood and perhaps in childhood. There is a curious relationship between Hodgkin's disease and Epstein-Barr virus infection. Persons with Epstein-Barr virus infection have an increased risk of developing Hodgkin's disease, and the Epstein-Barr virus infection precedes the development of Hodgkin's disease. The virus has never been isolated from or identified in Hodgkin's disease tissue. The mechanisms underlying this association are unknown and may provide important clues to the etiology of Hodgkin's disease and other lymphomas. It is likely that there is no direct person-to-person spread of Hodgkin's disease. This is suggested by several negative studies of linkages between cases, time-space clustering, and aggregation of exposures at schools. Studies have shown that neither physicians nor nurses, groups with greater likelihood of encountering Hodgkin's disease patients than the general public, have an increased risk. There appears to be familial aggregation of Hodgkin's disease. Siblings of young adult cases are at increased risk, whereas siblings of older adult cases have no increase in risk. Among sibling pairs with Hodgkin's disease, there is a marked excess of like-sex pairs. Like-sex siblings have almost twice the risk of discordant-sex siblings, suggesting an interaction between environmental and genetic factors. Thus, it would be of interest to known the risk to spouses of cases who share environments but who do not share genes.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1984

An approach to conducting epidemiologic research within cooperative clinical trials groups.

Cooperative clinical trials groups offer exciting opportunities for conducting epidemiologic research for several reasons: they facilitate accrual of sufficient numbers of subjects in a short period of time, even for studies of rare diseases; they provide uniform pathologic review and uniform collection of subjects' entry data; and they provide a more representative sample of cases than a single-institution study. Despite these advantages, few epidemiologic studies of etiologic factors have been done through these groups because methods for selecting appropriate control subjects and for obtaining information from geographically scattered subjects have not been available. An approach that can serve as a model for this type of research has been developed. A collaborative case-control study of childhood rhabdomyosarcoma (RMS) with the Intergroup Rhabdomyosarcoma Study (IRS) was recently begun. The study, which is independently funded, evaluates the role of environmental factors in the etiology of RMS. Parents of subjects were interviewed by telephone and control subjects were selected from the same communities as patients by random digit dialing . Interview data are supplemented by information from birth certificates and, for patients, by IRS data. This new methodology permits a large study of a rare tumor in a relatively short period of time.

Child↗
PubMed1983

An evaluation of space-time clustering in Hodgkin's disease.

A survey in Greater Boston identified 1577 new cases of histologically-confirmed Hodgkin's disease (HD) diagnosed from 1959 to 1973. The spatial position of each case was taken as the place of residence at diagnosis, and the temporal position as the month and year of diagnosis. Sufficient data for analysis were available for 1398 cases (89%). Space-time clustering was evaluated by three different methods: (a) Knox, (b) David and Barton and (c) Ederer, Myers and Mantel. When all HD cases were considered, none of these methods revealed statistically significant clustering. When stratification by risk factors was done, each of the techniques found significant clustering for various subgroups. Young adult cases (age 16-45 yr) tended to cluster more than older cases (age 46-70) and Catholics more than Jewish or Protestant cases. Rather than suggesting clustering at the time of HD diagnosis, the sporadic and inconsistently positive findings of this study may reflect case aggregation at the time of shared etiologic exposures, particularly if HD has a long and/or variable latent period.

Adolescent↗
PubMed1983

Parents' cigarette smoking and childhood cancer.

In our recent study of childhood rhabdomyosarcoma (RMS) we found an increase in the risk of RMS among children whose fathers smoked cigarettes. However, there was no association between RMS and mothers' smoking. We hypothesize that differential germ cell damage from cigarette smoking underlies our observations and that this risk of germ cell damage from cigarette smoking and from other environmental exposures is greater for men than for women. The increased susceptibility for male germ cells may be due to the number and timing of meiotic and mitotic cell divisions. In males, germ cells undergo large numbers of meiotic and mitotic divisions throughout the reproductive years. In contrast, in females, generally only one oocyte matures and completes meiosis each month of the reproductive years. Thus, there are very large male-female differences in the number of rapidly dividing germ cells during the reproductive years, and it is rapidly proliferating cells which are most susceptible to genetic damage. We conclude that fathers' environmental exposures before conception of their children may play a role in the etiology of childhood cancer.

Fathers↗
PubMed1983

Secular trends in ischemic heart disease mortality: regional variation.

We compared secular trends in ischemic heart disease (IHD) mortality in four southeastern states (North Carolina, Georgia, South Carolina, and Virginia) with those in three selected other states (California, New York, and Utah). Mortality data were obtained from U.S. vital statistics and population information from the U.S. Census Bureau. Age-adjusted IHD mortality increased until 1968 in the southeastern states and then declined and declines were greatest in the nonwhite female population. In contrast, IHD mortality in all groups in California and in the female population in New York and Utah began to decline in the early 1950s, with accelerated declines since 1968. In all states the decline in rates in nonwhite populations have been greatest in the younger age groups. This has not been true in the white populations. Declining IHD mortality correlated moderately well with the decline in death from all cardiovascular disease and from all causes, but not with the declining cerebrovascular disease mortality. Respiratory cancer mortality increased in similar proportions in California and South Carolina, two states with dissimilar IHD trends. These findings suggest that improved control of hypertension and changing patterns of cigarette smoking may not be responsible for the recent decline in IHD mortality.

Adult↗
PubMed1983

Cancer and other causes of death among female textile workers, 1976-78.

Information on usual industry and occupation on North Carolina death certificates indicated that 4,462 white women who died during 1976-78 were former textile industry employees. The relative frequency of cancer and other diseases among decreased textile workers was compared with the cause of death distribution among other white female decedents. Elevated proportional mortality ratios (PMR) were found for the following malignant neoplasms: larynx, PMR=2.8; connective tissue, PMR=2.6; uterine cervix, PMR=2.1; other and unspecified genital organs, PMR=2.7; thyroid, PMR=2.2; and non-Hodgkins lymphoma, PMR=1.7. The increased PMR for cervical cancer and for cancer of other and unspecified genital organs may be related to socioeconomic correlates of employment in the textile industry. More research is needed to determine whether work in the textile industry is associated with the other malignant neoplasms for which an elevated PMR was found in this study.

Aged↗
PubMed1982

Assessment of the use of the age- and sex-specific United States population as a control group for analysis of survival in coronary artery disease.

The use of the age- and sex-specific U.S. population as a control group for analysis of survival in coronary artery disease was assessed. Population-based survival rates were calculated for nonsurgically treated patients evaluated for coronary artery disease at Duke University Medical Center. Survival of the overall group of medically treated patients with significant coronary artery disease was lower than the corresponding age- and sex-specific U.S. population rates. However, survival of patients with significant disease who had normal left ventricular contraction and stable chest pain was similar to the age- and sex-specific population survival rates. Both the observed survival and the population-based survival estimates for patients with normal left ventricular contraction and stable pain were lower than the survival of patients with normal coronary arteriograms. Even after deaths from ischemic heart disease are eliminated from the population rates, survival of patients with normal coronary arteries exceeded the age-and sex-specific population survival. Because of biases inherent in the selection of patients for cardiac catheterization and the presence of other serious diseases in persons in the general population is not an adequate control group for rigorous analysis of the effect of therapy in coronary artery disease.

Actuarial Analysis↗
PubMed1982

Environmental factors in the etiology of rhabdomyosarcoma in childhood.

In a case-control study of childhood rhabdomyosarcoma (RMS), families of 33 cases and 99 controls were interviewed. A relative risk (RR) of 3.9 was found associated with fathers' (but not mothers') cigarette smoking (P = 0.003). Cases had had fewer immunizations than controls, particularly smallpox vaccination (RR = 0.2; P = 0.001), and conversely had more preventable infections. An RR of 3.2 (P = 0.03) was found associated with exposure to chemicals and and RR of 3.7 (P = 0.004) was found associated with diets that included organ meats. Mothers of cases were more likely to be over age 30 years at subject's birth, to have used antibiotics preceding or during pregnancy, and to have had an overdue and/or assisted delivery. Other findings suggest that low socioeconomic status is associated with an increased risk of RMS. These aggregate findings imply that environmental factors may play an important role in the etiology of childhood RMS.

Adolescent↗
PubMed1982

Carotid body tumors in humans: genetics and epidemiology.

Genetic factors in the etiology of carotid body tumors (CBT) were sought in a medical record review of 222 histologically diagnosed cases at 12 U.S. medical centers. Patients in the series, which had a marked female predominance (146 females:76 males), usually developed tumors between the fourth and seventh decades of life (mean, 44.7 yr). In 16 patients who also had other extra-adrenal paragangliomas, suggesting a multiple primary tumor syndrome, CBT were diagnosed significantly earlier (mean, 35.4 yr; P less than 0.01). The occurrence of thyroid cancer in 5 other patients appeared to be excessive. Familial CBT was recognized in 16 patients from 13 affected families, including 9 newly ascertained kindreds. Compared with non-familial lesions, familial CBT tended to develop bilaterally (38% vs. 8% unilaterally) and at slightly earlier ages (41.6 vs. 44.9 yr). CBT was reported to occur in an autosomal dominant pattern in some families and within sibships in others; relatives were not examined for confirmation. The familial findings are generally consistent with a two-step mutation model of the development of hereditary and nonhereditary CBT; apparent deviations from the model might be clarified with additional data on this rare neoplasm.

Adolescent↗