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Biomedical subjects

S Ramcharan

Publications and source records attributed to S Ramcharan.

At least 19 recordsLinked to original sources
PubMed1992

Effect of oral contraceptive use on reoperation following surgery for Crohn's disease.

The influence of oral contraceptive (OCP) use as a risk factor for the development of Crohn's disease is disputed. We wished to determine if OCP use affected the risk of recurrence (defined as need for a second surgery) in women who had already undergone a resection for Crohn's disease. We hypothesized that if contraceptive use was a risk factor for disease development, it could influence recurrence. Using a mail questionnaire, we surveyed 138 women regarding their OCP use following surgery for Crohn's disease. All participants were between ages 16 and 35 at the time of their initial surgery which occurred between 1966 and 1984. Ninety-seven women (70%) responded. Mean follow-up was 9.9 years (range 4-27). Forty-six women required a second surgery. The recurrence rate as determined by actuarial analysis, was 27.2% (95% confidence intervals (CI95 16.5-38.1) and 58.0% (CI95 37.8-78.2) at 5 and 10 years, respectively. Thirty-two women took OCP in the first year following surgery. Eleven OCP users (34.4%) required additional surgery compared to 34 (53.1%) of nonusers. Using life table analysis, the percentage requiring a second surgery was 25.0% (CI95 6.9-43.1) and 40.7% (CI95 1.5-80%) at 5 and 10 years, respectively, for users compared to 28.4% (CI95 6.9-43.1) and 64.0% (CI95 40.5-87.5) for nonusers (Lee Desu, P greater than 0.05). When surveyed about their reasons for using OCP, most women stated that their disease did not affect their decision to use contraceptives.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

The epidemiology of premenstrual symptoms in a population-based sample of 2650 urban women: attributable risk and risk factors.

This epidemiologic survey achieved a reliable measure of the prevalence of premenstrual symptoms by avoiding the biases of small or selected samples, anamnestic error, and subjective expectation. From 6232 women (a 78.8% response), aged 20-49 years, identified through a random sample of urban households, the 24-hour prevalence of symptoms was obtained using the Moos' Menstrual Distress Questionnaire, administered without reference to the menstrual cycle. For 71% of the naturally cycling women, current cycle phase was determined by follow-up (n = 2650); but a higher prevalence of severe or moderately severe affective symptoms in the premenstrual compared to the mid-cycle phase was not found. However, observed risk factor interactions led to the conclusion that premenstrual distress is a discrete mood disorder, affecting women aged 25-35 years, with probable ovulatory cycles, and vulnerable to stress; and that the risk of affective symptoms attributable to the premenstrual state was one percent.

Adult↗
PubMed1990

Effect of cigarette smoking on recurrence of Crohn's disease.

The effect of cigarette smoking on recurrence (defined in this study as the need for repeat surgery) in patients who had previously required surgery for Crohn's disease was assessed in a historical cohort of 174 patients. Mean follow-up was 10.8 yr. The 5- and 10-yr recurrence rates were 28% and 56%, respectively. Five- and 10-yr rates were significantly different for smokers (36%, 70%) and nonsmokers (20%, 41%). When patients were stratified by gender, the increased risk was more apparent in women (odds ratio 4.2, 95% confidence interval 2.0-4.2) than in men (odds ratio 1.5, 95% confidence interval 0.8-6.0). Evidence for a dose-response relationship could be identified in women but not men. Cigarette smoking may not only be a risk factor for development of Crohn's disease but also may influence disease activity following surgery.

Alberta↗
PubMed1989

Cancer mortality of Chinese in Canada.

Cancer deaths determined from national vital statistics in Canadian ('Chinese') immigrants who were born in mainland China, Hong Kong or Taiwan were compared with those in the Canadian-born population. Standardized mortality ratios (SMR) based on 1981 census data and on 755 deaths among 81,740 Chinese males and 586 deaths among 83,965 females during 1980-1984, showed that the overall cancer mortality in Chinese males (SMR 141), and females (SMR 116), was significantly higher than in the Canadian-born. Moreover, SMR varied by cancer site and showed a pattern of risks similar to those reported for foreign-born Chinese in the USA: strikingly high SMR for nasopharynx and liver or gallbladder in males and females; high ratios for stomach, intestines or colon, rectum, and lung, but a low ratio for prostate in males; and high ratios for lung and cervix uteri but low ratios for breast and ovary in females. These findings indicate that useful studies on cancer mortality could be carried out in Canadian Chinese.

Adolescent↗
PubMed1985

Chromosomal abnormalities in the Kaiser-Permanente Birth Defects Study, with special reference to contraceptive use around the time of conception.

Chromosomal abnormalities were studied in 33,551 abortions and births to women whose contraceptive histories had been recorded at their first antenatal visit in 1975-1977. Chromosome examinations were performed exclusively on clinical grounds. There were 45 de novo abnormalities detected (1.34/1,000); three of them were detected at amniocentesis. Trisomy 21 was observed in 27 cases (0.80/1,000), trisomy 18 in nine (0.27), other trisomies in three (0.09), and translocations or deletions in five (0.15). One case of triploidy and six cases of inherited abnormalities were detected. There were no significant racial variations. No increase in risk for chromosomal abnormalities was found among women who had used oral contraceptives prior to becoming pregnant or among women who experienced oral contraceptive breakthrough pregnancies. Two cases of trisomy 18 were observed among the 814 deliveries following oral contraceptive breakthrough conceptions (2.46/1,000), two cases of trisomy 21 occurred in 338 births following failures of rhythm contraception (5.92/1,000), and no cases of trisomy 21 or 18 among the 1,569 women using spermicides at the time of conception.

Abnormalities, Drug-Induced↗
PubMed1985

Congenital abnormalities in the offspring of women who used oral and other contraceptives around the time of conception.

Congenital malformations were observed in 33,545 newborns whose mothers were questioned during pregnancy about contraceptives used around the time of conception. There were 597 babies (17.8/1,000) with major malformations and 4,046 (120.6/1,000) with minor ones. The 8,522 offspring of mothers who had used oral contraceptives (OC) prior to conception showed 17.2/1,000 major malformations compared with rates of 15.0 and 20.1/1,000 in the groups who had used other methods or no birth control prior to conception. There was no evidence for an increased risk of malformations in women conceiving within 1 month of stopping OC. There were 850 babies exposed to OC in utero and the ratio of observed to expected cases of major malformations was 1.24 (n.s.) if the mother was a nonsmoker and 2.98 (P = 0.028) if the mother smoked one pack or more of cigarettes daily. There were no significant changes in malformation rates following failures of intrauterine devices, spermicides or rhythm contraception.

Abnormalities, Drug-Induced↗
PubMed1979

A prospective study of spontaneous fetal losses after induced abortions.

The incidence of spontaneous abortions was observed among 31,917 women followed from their first prenatal visit. Life-table analysis showed that losses in the first trimester were not significantly affected by previous induced abortions, nor was any change in the risk of second-trimester losses detected among the 1493 parous women who reported having had induced abortions after childbirth. There was, however, an increase in the incidence of midtrimester losses among the 2019 nulliparous women with previous induced abortions; the age-adjusted rate of loss was 59.9 per 100,000 women at risk per day, as compared with 24.2 among the 12,042 control nulliparous women (P less than 0.001). The relative risk increased with the number of previous induced abortions and was not explained by the distribution of demographic and social variables. The risk decreased from 3.27 (95 per cent confidence limits, 1.72 to 6.23) after abortions induced before 1973, mainly by dilation and curettage, to 1.42 (0.76 to 2.65) after those done since 1973, when the more gentle technic of cervical dilation by use of laminaria was introduced. These findings indicate that there is little or no risk of spontaneous abortions after induced abortions when performed by current technics.

Abortion, Induced↗
PubMed1979

Risk of vascular disease in women. Smoking, oral contraceptives, noncontraceptive estrogens, and other factors.

We investigated the relation in women of various factors to risk of myocardial infarction, subarachnoid hemorrhage, other strokes, and venous thromboembolism. Smoking significantly increased risk of all four diseases, whereas oral contraceptive use was associated with an increase only in risk of subarachnoid hemorrhage and venous thromboembolism. Use of noncontraceptive estrogens was not associated with increased risk of any of these diseases. Hypertension, hypercholesterolemia, obesity, gallbladder disease, and nondrinking of alcohol were all associated with increased risk of myocardial infarction, whereas only hypertension and hypercholesterolemia were associated with increased risk of other strokes. Cigarette smoking was overwhelmingly the most important risk factor for vascular disease in women. Smoking should be considered a contraindication to oral contraceptive use, or at the very least, women wishing to use oral contraceptives should be strongly urged not to smoke.

Adolescent↗
PubMed1979

Use of contraceptives prior to and after conception and exposure to other fetal hazards.

In a large prospective study, set up to determine whether reproductive outcomes are affected by prior contraceptive use, 34,344 women were recruited at their first antenatal visit and followed until pregnancy termination. This paper summarizes the study methods and describes the demographic differences between subjects who used various contraceptives shortly before conception, and those who experienced contraceptive failures. Thirty percent of the women had used oral contraceptives (OCs) during the 5 months prior to conception and 2.4% had continued using them after their LMP. IUDs had been used by 5.8% of women before conception and 1.1% after. If these rates are also true for the whole population of the U.S., they indicate that approximately 70,000 babies are born each year following pill-failures and 30,000 following failures of IUD's. Exposure to other fetal hazards was common, with 48% of pregnant women drinking alcohol, 28% smoking, and 15% receiving diagnostic X-rays. OC use was more common among smokers and drinkers, and OC failures were significantly associated with the use of anti-epileptics, aspirin, and with exposure to radiation.

Adult↗
PubMed1978

Serum high-density-lipoprotein cholesterol in women using oral contraceptives, estrogens and progestins.

To determine the associations between high-density-lipoprotein cholesterol levels and use of oral contraceptives or of noncontraceptive estrogens and progestins we analyzed the serum levels of this lipid in 4978 women, 21 to 62 years of age. In estrogen users, the mean level was 6.7 to 15.1 mg per deciliter above the nonuser level (P less than 0.001), whereas in a group of progestin users it was 15.8 mg per deciliter below (P less than 0.001). In women using combination oral contraceptives, the level varied with the type and dose of the component steroids, in general increasing with increasing dose of estrogen and decreasing with increasing dose or potency of progestin. Thus, the net effect of use of a combination oral contraceptive on high-density-lipoprotein cholesterol depends on its formulation.

Adult↗
PubMed1978

Oral contraceptives, smoking, and other factors in relation to risk of venous thromboembolic disease.

Analysis of data from the Walnut Creek Contraceptive Drug Study showed a significant increase in risk of venous thromboembolic disease in the absence of surgery, trauma, malignancy, pregnancy, and the puerperium for women with a previous history of thromboembolism, hypertension, diabetes, varicose veins, gallbladder disease, and cigarette smoking. Education, marital status, parity, use of noncontraceptive estrogens, and obesity were not associated with an increase in risk of the disease. When only cases of the disease in the absence of all known predisposing causes (idiopathic cases) were analyzed, both oral contraceptive use and smoking remained as independent risk factors; there was no evidence of a positive interaction between them.

Adult↗
PubMed1977

Malignant melanoma and oral contraceptive use among women in California.

Women who had used oral contraceptives, particularly long-term users, were found to have higher rates of malignant melanoma and of a past history of skin cancer than those who had never used oral contraceptives. This excess was confined to lesions of the lower limb. The association between oral contraceptive use and melanoma was noted in 3 separate sets of data, although it was statistically significant only in one. The possibility that this relationship is indirect because, for example, oral contraceptive users are more likely than never-users to be exposed to sunlight and thus to develop malignant melanoma, cannot be excluded.

Adult↗
PubMed1977

The incidence of cervical cancer and duration of oral contraceptive use.

In a prospective study carried out on a cohort of 17,942 women belonging to the Kaiser Foundation Health Plan and living in suburban communities of the San Francisco Bay Area, a positive association was found between the incidence of cervical carcinoma and total duration of oral contraceptive use. The association was established while controlling for the effects of age, education, and selected infections. The association persists when incident cases of dysplasia are added to those of carcinoma. A further study, in which covariates relating to sexual behavior will also be taken into account, is in progress.

Adolescent↗
PubMed1976

Serum protein fractions. Effects of oral contraceptives and pregnancy.

As a part of a longitudinal study to determine the side effects of oral contraceptive drugs (OCs), protein electrophoresis studies were carried out on sera obtained from 4057 current users of OCs, 9774 nonusers, and 624 women in the first trimester of pregnancy. Albumin and gamma globulin levels were lower in OC users than in nonusers; alpha-1, alpha-2, and beta fractions were higher. A similar effect was observed during the first trimester of pregnancy. The changes were temporary and reverted to normal within 12 weeks of OC withdrawal. The dosage of the estrogenic component appeared to be directly related to the lower concentration of albumin in users. The mechanisms of these changes were not well identified but very likely represent a direct effect on the metabolism of proteins.

Adult↗