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Biomedical subjects

S J Otto

Publications and source records attributed to S J Otto.

14 recordsLinked to original sources
PubMed2004

Decreased rates of advanced breast cancer due to mammography screening in The Netherlands.

The effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The Netherlands Cancer Registry provided detailed data on breast cancer incidence in 1989-1997 by tumour stage, age and region. Annual age-adjusted incidence rates of all breast cancers and advanced cancers, defined as large tumours T2+ with lymph node and/or distant metastases, were compared with rates in 1989. In general, breast cancer incidence rose strongly in the early 1990s, especially in the age category 50-69 years (estimated annual percentage change (EAPC) 4.25; 95% CI 1.70, 6.86). The increase was mainly due to the increase in small T1 cancers and ductal carcinoma in situ. However, in women aged 50-69, advanced cancer incidence rates showed a significant decline by 12.1% in 1997 compared with 1989 (EAPC -2.14, 95% CI -3.47, -0.80), followed by a breast cancer mortality reduction of similar size after approximately 2 years. We confirm that breast cancer screening initially leads to a temporary strong increase in the breast cancer incidence, which is followed by a significant decrease in advanced diseases in the women invited for screening. It is evident that breast cancer screening contributes to a reduction in advanced breast cancers and breast cancer mortality.

Adult↗
PubMed2004

Low all-cause mortality in the volunteer-based Rotterdam section of the European randomised study of screening for prostate cancer: self-selection bias?

OBJECTIVES: The likelihood of self-selection bias in a cohort of men that entered the volunteer-based randomised prostate cancer screening trial was assessed. In addition, the accuracy of the randomisation was evaluated by comparison amongst the trial arms. SETTING: The Rotterdam section of the European Randomised Study of Screening for Prostate Cancer (ERSPC). Participants were recruited from population registries and randomised after receipt of written informed consent (49% participation rate). METHODS: Data from 37,614 men who entered the Rotterdam trial between June 1994 and July 1999 were linked to the Causes of Death Registry of Statistics Netherlands. For the assessment of self-selection bias, mortality in the trial cohort and the area of Rotterdam was compared by calculating standardised mortality ratios (SMRs, 95% confidence interval [CI]). Comparisons between the screening and the control arm were made by means of relative risk (RR). RESULTS: There were a total of 1661 deaths (4.4%) in the trial cohort, during an average follow-up time of 2.8 years. The observed number of deaths in the two arms combined was lower than expected (SMR 86.7%, 95% CI 81.6-92.1), which was reflected in the major cause of death categories, especially in all malignant neoplasms. No difference was observed in the all-cause mortality rate among the screening and control arm, aged 55-69 years at entry (RR 1.00, 95% CI 0.89-1.12), nor when all causes, excluding prostate cancer mortality, were considered. CONCLUSIONS: The preliminary results show that the screening and the control arm were comparable, but men recruited for the trial seemed healthier than men in the target population.

Aged↗
PubMed2003

Increased risk of postpartum depressive symptoms is associated with slower normalization after pregnancy of the functional docosahexaenoic acid status.

Observational studies suggest an association between a low docosahexaenoic acid (DHA, 22:6n-3) status after pregnancy and the occurrence of postpartum depression. However, a comparison of the actual biochemical plasma DHA status among women with and without postpartum depression has not been reported yet. The contents of DHA and of its status indicator n-6 docosapentaenoic acid (n-6DPA, 22:5n-6) were measured in the plasma phospholipids of 112 women at delivery and 32 weeks postpartum. At this latter time point, the Edinburgh Postnatal Depression Scale (EPDS) questionnaire was completed to measure postpartum depression retrospectively. The EPDS cutoff score of 10 was used to define 'possibly depressed' (EPDS score > or =10) and non-depressed women (EPDS score <10). Odds ratios (OR) were calculated using a multiple logistic regression analysis with the EPDS cutoff score as dependent and fatty acid concentrations and ratio's as explanatory variables, while controlling for different covariables. The results demonstrated that the postpartum increase of the functional DHA status, expressed as the ratio DHA/n-6DPA, was significantly lower in the 'possibly depressed' group compared to the non-depressed group (2.34+/-5.56 versus 4.86+/-5.41, respectively; OR=0.88, P=0.03). Lactating women were not more predisposed than non-lactating women were to develop depressive symptoms. From this observation it seems that the availability of DHA in the postpartum period is less in women developing depressive symptoms. Although further studies are needed for confirmation, increasing the dietary DHA intake during pregnancy and postpartum, seems prudent.

Adult↗
PubMed2001

Leptin and phospholipid-esterified docosahexaenoic acid concentrations in plasma of women: observations during pregnancy and lactation.

BACKGROUND: The n-3 fatty acid status changes during pregnancy and lactation. Plasma leptin concentrations and gene expression have been related to n-3 fatty acids. OBJECTIVE: To investigate the relation between plasma leptin concentration and the docosahexaenoic acid (22:6n-3) content of plasma phospholipids during early pregnancy and the postpartum period. DESIGN: Leptin (radioimmunoassay) and the phospholipid fatty acid profile (capillary gas-liquid chromatography) were measured in plasma of women during two independent longitudinal observational studies. Dietary intake of n-3 fatty acids was also determined. RESULTS: Within the first 10 weeks after the last menstrual period, an almost parallel increase in leptin concentration and the 22:6n-3 content (mg/l and % wt/wt) of plasma phospholipids was seen (study 1, n = 21). During the postpartum period (study 2, n = 57), leptin levels decreased quickly, preceding the changes in 22:6n-3 concentrations. During both studies, leptin concentrations did not consistently relate to dietary intake of n-3 fatty acids or to 22:6n-3 concentrations in plasma phospholipids. Before and during early pregnancy (study 1), significant positive associations between leptin levels and the total amount of phospholipid-associated fatty acids were found. No such association was seen during late pregnancy or the postpartum period (study 2). The postpartum decrease in leptin levels did not differ between lactating and non-lactating women. CONCLUSIONS: Not the 22:6n-3 content, but the total amount of phospholipid-associated fatty acids was related to plasma leptin concentration, before and during early pregnancy but not during late pregnancy and the postpartum period.

Body Mass Index↗
PubMed2001

Changes in the maternal essential fatty acid profile during early pregnancy and the relation of the profile to diet.

BACKGROUND: Although the pattern of the essential fatty acids (EFAs) changes considerably from week 10 of pregnancy to term, no information is available on changes in EFA concentrations in the early stages of pregnancy. OBJECTIVE: The main objectives were to assess the EFA status, particularly that of 22:6n-3, in women during the first 10 wk of pregnancy and to investigate the relation of EFA status to dietary EFA intake during this period. DESIGN: Healthy women (n = 24) planning to become pregnant were recruited. The fatty acid composition of plasma and erythrocyte phospholipids was determined before and at weeks 4, 6, 8, and 10 of pregnancy. Food intake was assessed at entry into the study and at week 10 of pregnancy by using food-frequency questionnaires. RESULTS: A small but nonsignificant increase in dietary intake of 22:6n-3 was found. The plasma phospholipid content of 22:6n-3 (% by wt) increased continuously during the first 10 wk of pregnancy. At week 10 of pregnancy, the plasma percentages of 16:0, 20:3n-6, and 20:4n-6 had increased significantly, whereas the percentages of the 18-24-carbon saturated fatty acids, 18:2n-6, and the ratio of n-6 to n-3 fatty acids had dropped significantly. The composition of erythrocyte phospholipids showed changes similar to those observed in plasma. CONCLUSIONS: Maternal plasma and erythrocyte phospholipid 22:6n-3 concentrations start to increase in very early pregnancy, which cannot be explained by changes in dietary intake alone. This rise probably represents early maternal adaptations to meet the requirements of highly proliferating and differentiating tissues at this stage of fetal development.

Adult↗
PubMed2001

Comparison of the peripartum and postpartum phospholipid polyunsaturated fatty acid profiles of lactating and nonlactating women.

BACKGROUND: Pregnancy is associated with increased absolute amounts of docosahexaenoic acid (DHA; 22:6n-3) in plasma phospholipids. Expressed as a proportion of total fatty acids, DHA declines slightly in late pregnancy but little information is available on the normalization of DHA postpartum, which may be different in lactating and nonlactating women. OBJECTIVE: The aim was to investigate maternal plasma and erythrocyte long-chain polyunsaturated fatty acids (long-chain polyenes; LCPs) postpartum, particularly DHA, in relation to lactation and dietary LCP intake. DESIGN: Healthy pregnant women who intended to breast-feed or exclusively bottle-feed their infants were studied at 36-37 wk of pregnancy. Blood samples were collected at entry, after parturition on days 2 and 5, and 1, 2, 4, 8, 16, 32, and 64 wk postpartum. Fatty acid profiles were analyzed in plasma and erythrocyte phospholipids. Dietary intakes were assessed 4 and 32 wk postpartum with a validated food-frequency questionnaire. RESULTS: After delivery, the percentages of plasma linoleic, arachidonic, eicosapentaenoic, and docosapentaenoic acids increased over time, whereas the percentage of docosapentaenoic acid decreased; the patterns of change did not differ significantly between the lactating and nonlactating groups. The percentage of DHA in plasma and erythrocyte phospholipid fatty acids declined significantly in the 2 groups, more so in the lactating women, and was enhanced when the lactation period was extended. Despite the apparent higher dietary intake of essential fatty acids in the lactating group at week 4, it was not significantly different from that of the nonlactating group. CONCLUSION: Normalization of maternal plasma and erythrocyte phospholipid n-3 LCPs differs significantly between lactating and nonlactating women postpartum but that of n-6 LCPs does not.

Adult↗
PubMed2000

The effect of supplementation with docosahexaenoic and arachidonic acid derived from single cell oils on plasma and erythrocyte fatty acids of pregnant women in the second trimester.

This study was performed to investigate whether supplementation of docosahexaenoic acid (DHA) and arachidonic acid (AA) to pregnant women would enhance their DHA levels, both in plasma and in erythrocyte phospholipids, without reducing the content of n-6 long-chain ployenes (LCP) usually seen when DHA is supplemented alone. Healthy pregnant women, in the second trimester, were randomly assigned to either the control group (n=12) or the intervention group (n=12). The control group received no supplements and the intervention group received daily during 4 weeks encapsulated algae-derived DHA oil (0.57 g DHA/day) and fungal-derived AA oil (0.26 g AA/day). The fatty acid compositions of plasma and erythrocyte phospholipids were determined in weekly-collected blood samples. DHA and n-6 LCP levels of the control group were unchanged after 4 weeks. Compared to the control group, DHA levels in plasma an erythrocytes of the intervention group increased significantly. No significant reductions were found in the levels of AA and total n-6 LCP. The supplement proved to be effective in increasing the DHA levels in both plasma and erythrocyte without a concomitant decline of the n-6 LCP.

Adult↗
PubMed1998

Microprocessor controlled movement of liquid gastric content using sequential neural electrical stimulation.

BACKGROUND: Gastric electrical stimulation has been attempted for several years with little success. AIMS: To determine whether movement of liquid gastric content could be achieved using microprocessor controlled sequential electrical stimulation. METHODS: Eight anaesthetised dogs underwent laparotomy and implantation of four sets of bipolar stainless steel wire electrodes. Each set consisted of two to six electrodes (10x0.25 mm, 3 cm apart) implanted circumferentially. The stomach was filled with water and the process of gastric emptying was monitored. Artificial contractions were produced using microprocessor controlled phase locked bipolar four second trains of 50 Hz, 14 V (peak to peak) rectangular voltage. In four of the dogs four force transducers were implanted close to each circumferential electrode set. In one gastroparetic patient the effect of direct electrical stimulation was determined at laparotomy. RESULTS: Using the above stimulating parameters circumferential gastric contractions were produced which were artificially propagated distally by phase locking the stimulating voltage. Averaged stimulated gastric emptying times were significantly shorter than spontaneus emptying times (t1/2 6.7 (3.0) versus 25.3 (12.9) minutes, p<0.01). Gastric electrical stimulation of the gastroparetic patient at operation produced circumferential contractions. CONCLUSIONS: Microprocessor controlled electrical stimulation produced artificial peristalsis and notably accelerated the movement of liquid gastric content.

Animals↗
PubMed1997

Maternal and neonatal essential fatty acid status in phospholipids: an international comparative study.

OBJECTIVE: To investigate whether the steady decline in the maternal essential fatty acids (EFA) status during pregnancy observed in Dutch pregnant women is a local or general phenomenon. DESIGN: The EFA status was measured during uncomplicated, singleton pregnancy of healthy women from the Netherlands, Hungary, Finland, England and Ecuador. In addition, the EFA status of their neonates were measured at birth. Fatty acid profiles were analyzed in phospholipids isolated from maternal plasma and from umbilical plasma and cord vessel walls. RESULTS: Considerable differences between these centers were observed in the maternal EFA levels and EFA status indexes. However, the change in the absolute as well as relative amounts of the EFAs followed a similar course in the five populations during pregnancy. The neonatal EFA profiles reflected the differences found in maternal plasma during pregnancy and shortly after delivery. Comparable correlations were found, particularly, between the neonatal and the maternal n-3 fatty acids in the participating groups. CONCLUSIONS: It seems that the reduction in maternal EFA status during pregnancy is a general phenomenon, and is largely independent of differences in dietary habits and ethnic origin. Since the lowest values for certain maternal EFAs in a given country were significantly higher than the highest value of these EFAs throughout pregnancy in other countries, the functional implications of the pregnancy-associated reduction in the maternal EFA status for the fetal and neonatal development is not obvious and needs to be further elucidated.

Adult↗
PubMed1997

Electrogastrography can recognize gastric electrical uncoupling in dogs.

BACKGROUND & AIMS: Electrical uncoupling is the lack of electrical synchronization in different parts of the stomach. The ability of electrogastrography (EGG) to recognize gastric electrical uncoupling has not been adequately studied. The aim of this study was to determine the impact on EGG of surgically introduced gastric uncoupling in anesthesized dogs. METHODS: Six pairs of bipolar electrodes were inserted into the antral gastric wall of 16 anesthetized dogs at laparotomy. Eight-channel bipolar cutaneous EGGs were simultaneously recorded. Three separate half-hour recordings were made from each dog in the basal state and after each of two circumferential cuts of all gastric muscle. The stomach was divided into three equally sized areas, each with an electrode pair in its anterior and posterior walls. Gastric electrical activity was assessed visually. EGG was digitized and processed by computer. RESULTS: Criteria for EGG normality were defined from 9 dogs with normal gastric electrical activity. After the first antral cut, internal recordings from the area below the division were at a lower frequency and often irregular. The second cut produced three different frequencies. Suggested criteria for normality allowed correct recognition of 93% of all severely abnormal records. Records with mild gastric electrical abnormalities were recognized with a sensitivity of 74%. CONCLUSIONS: EGG can recognize severe electrical uncoupling.

Animals↗
PubMed1997

Reliability of percent distribution of power of the electrogastrogram in recognizing gastric electrical uncoupling.

The aim of this study was to examine the reliability of percent distribution of electrogastrographic (EGG) power in recognizing gastric electrical uncoupling. Sixteen anaesthetized dogs underwent laparotomy and implantation of six pairs of stainless-steel wire electrodes. Distal stomach was measured and three sections with approximately equal lengths were defined. Two pairs of electrodes were implanted in each section. Eight-channel EGG was also recorded. Three separate half-hour recordings were made: in the basal state; after a full circumferential separation of the distal antral section from the rest; after a second circumferential cut completely separating the middle from the proximal sections. EGG digital power spectra were split into three frequency ranges and dynamics of percent distribution of power was statistically examined. After the first cut, changes in the percent distribution of EGG power in the normal range were not significant (p = 0.2). Significant changes in the low range were noted (p < 0.05) and changes in the high range were borderline nonsignificant (p = 0.056). After the second cut, changes in percent distribution in the normal and the high range became significant (p < 0.01) while changes in the low range were insignificant (p = 0.075). Severe uncoupling was reflected in EGG by significant changes in the high-frequency range without internal tachygastria necessarily being present.

Animals↗
PubMed1997

Effects of storage on venous and capillary blood samples: the influence of deferoxamine and butylated hydroxytoluene on the fatty acid alterations in red blood cell phospholipids.

Fatty acid concentrations in plasma and red blood cell phospholipids isolated from paired venous and capillary blood samples were compared and the effect of storage at -20 degrees C was evaluated as well. Plasma fatty acid profiles from venous and capillary blood were found to be comparable and not affected by up to four weeks of storage, while fatty acid profiles of venous and capillary red blood cells were no longer comparable after four weeks. Substantial losses of long-chain polyunsaturated fatty acids were observed in capillary red blood cells. To investigate whether the observed long-chain polyunsaturated fatty acids loss could be prevented, capillary red blood samples were stored for up to one year at -50 degrees C in the presence of the iron-binding agent deferoxamine or the free radical scavenger butylated hydroxytoluene. Both compounds protected the long-chain polyunsaturated fatty acids. Similarly, storage of red blood cell lipid extracts at -50 degrees C for up to one year was not associated with reduced levels of long-chain polyunsaturated fatty acids. In conclusion, the lipid loss from capillary red blood cells can be reduced for at least one year during storage at -50 degrees C with prior addition of either a metal chelating compound or a free radical scavenger, or by preparing lipid extracts of the samples within one week of blood collection.

Blood Preservation↗