Biomedical subjects

T Adera

Publications and source records attributed to T Adera.

11 recordsLinked to original sources

PubMed2001

Cyclical mastalgia: prevalence and associated health and behavioral factors.

Perimenstrual breast pain (cyclical mastalgia) is a common problem that can be sufficiently severe to interfere with usual activities, and has been associated with elevated mammography usage in young women. This study was undertaken to replicate clinic-based research on cyclical mastalgia, and to examine the association between this disorder and health-related behaviors and perceived stress. Using random digit dialing throughout Virginia, 874 women aged 18-44 were interviewed. Sixty-eight per cent of women experienced cyclical breast symptoms; 22% experienced moderate to extreme discomfort (classified as cyclical mastalgia). Hormonal contraceptive usage was associated with significantly less mastalgia and premenstrual syndrome (PMS). Smoking, caffeine consumption and perceived stress were associated with mastalgia (odds ratios = 1.52, 1.53 and 1.7, respectively). Young women (under 35 years) with mastalgia were more likely to have had a mammogram (20.2%) than those without mastalgia (9.9%). Most women with this disorder (77.5%) did not have PMS. The prevalence of cyclical mastalgia and its association with mammography replicate clinic-based findings. Associations with smoking and stress had not previously been reported. Prospective research is needed to determine the biopsychosocial factors contributing to this disorder.

Adolescent↗

PubMed1998

Human brain tumors and exposure to metal and non-metal elements: a case-control study.

BACKGROUND: Primary brain tumors are among the most deadly of all cancers, with a 1-year survival rate of 52%. Certain elements, such as nickel, cadmium, chromium, arsenic, and beryllium, are established carcinogens in other organs. Silicon and titanium are suspected carcinogens and other elements are known to promote or inhibit the rate of tumor growth. Knowledge about the carcinogenicity of these elements in the brain is limited. In this study, we investigated the potential role of these elements as risk factors for human brain tumors. METHODS: In a case-control study, we assessed brain biopsies from 12 patients with various types of primary brain tumors and in tumor-free brain tissue from 6 autopsy cases. We used energy-dispersive X-ray analysis (EDX) to determine if there were significant differences in the concentration of the study elements in tumors and in control brains. RESULTS: In a bivariate analysis, a statistically significant association was observed between the presence of brain tumors and the concentrations of silicon (p = 0.01), magnesium (p = 0.01), and calcium (p = 0.03). Zinc was also associated with a borderline significance (p = 0.05). No association was observed for nickel (p = 0.74). Although the magnitude of the observed association was estimated using multiple logistic regression analyses, the relative risk estimates were imprecise because of insufficient sample size. Further research using a larger sample size is needed to elucidate the role of these elements in human brain carcinogenesis.

Aged↗

PubMed1997

Identifying comparison groups for evaluating occupational hearing loss: a statistical assessment of 22 industrial populations.

Finding appropriate comparison groups to study occupational hearing loss has been difficult. Recently, however, the National Institute for Occupational Safety and Health sponsored the complication of potentially useful data from 22 diverse industrial companies in the U.S.A. and Canada. We conducted a statistical evaluation to determine which of the 22 populations might be suited as comparison groups in future studies of workers exposed to hazardous noise. In a Cox Proportional Hazards model that included age and sex, the relative risk of developing hearing loss in each company was estimated at two, five, and ten years of follow-up. We ranked the companies based on their relative risks, and rated them on a five-point scale from "excellent" to "poor" to indicate their suitability as comparison groups. The risk profiles developed and other variables described in this study will assist researchers in selecting appropriate comparison groups for evaluating occupational hearing loss.

Age Distribution↗

PubMed1995

Risk factors for malaria among expatriates living in Kampala, Uganda: the need for adherence to chemoprophylactic regimens.

This investigation was conducted in response to a report of an increased number of malaria cases among United States Embassy personnel in Kampala, Uganda in the spring of 1992. The objectives of the investigation were to determine if an outbreak had occurred, to identify potential risk factors for malaria in this population, and to assess the effectiveness of various chemoprophylactic regimens. The risk of developing malaria during the first half of 1992 was more than six times greater than during the same time period in 1991 (relative risk [RR] = 6.6, 95% confidence interval [CI] = 1.6-27.8) and almost seven times greater than all the previous six years combined (RR = 6.8, 95% CI = 2.9-15.9). In this outbreak, children and young adults less than 20 years of age had more than a three-fold increase in risk (RR = 3.7, 95% CI = 0.7-19.8) than those in the 20-39-year-old age group. African-Americans had a six-fold increased risk compared with Caucasians (RR = 6.0, 95% CI = 1.6-22.7). Those who did not take any drug prophylaxis were 10 times more likely to develop malaria (RR = 10.0, 95% CI = 2.7-37.0) than those who took mefloquine, doxycycline, or chloroquine plus proguanil. In this setting, weekly mefloquine was 82% more effective, and chloroquine plus proguanil was 92% more effective than weekly chloroquine alone. This outbreak underscores the need for compliance with appropriate chemoprophylactic regimens in preventing malaria infection.

Adolescent↗

PubMed1995

Should the audiometric database analysis method (draft ANSI S12.13-1991) for evaluating the effectiveness of hearing conservation programs be accepted as a US national standard?.

The value of audiometric database analysis (ADBA) procedures for evaluating the effectiveness of hearing conservation programs (HCPs) was studied in a population of 82,195 workers. We rated the HCP using four ADBA procedures. Results showed that the HCP ratings ran the gamut from "unacceptable" to "acceptable" from year to year and from procedure to procedure. A mere 7 percent of the total population was eligible for ADBA analysis. This drastically reduced sample size precludes subgroup analyses of even a large cohort and likely could not be applied to the HCPs of most small- and medium-sized businesses. The low levels of agreement observed (weighted kappa = 15%-25%) between the ADBA procedures reflect poor validity. Generalizability of these results would be inappropriate when so few nonrandomly selected individuals contribute to the evaluation. In view of these problems, acceptance of the ADBA method as a national standard may not be warranted.

Audiology↗

PubMed1994

Premature menopause and low back pain. A population-based study.

The association between premature menopause and low back pain was examined among 5325 women surveyed in the second National Health and Nutrition Examination survey. Nearly 49% of the women were postmenopausal. In a multiple logistic regression model that included age, postmenopausal women were approximately twice as likely to report low back pain compared to premenopausal women (odds ratio = 2.1; 95% confidence interval: 1.4-3.0). Among postmenopausal women, significant positive trends in low back pain were observed with decreasing age at menopause (P = 0.005) and increasing years since menopause (P = 0.004). The prevalence odds ratio for women who had their menopause before the age of 30 was 3.2 (1.8-5.4); and for women who had their menopause for 15 or more years the odds ratio was 3.0 (1.7-5.3). These findings suggest that premature menopause is associated with low back pain. Further studies appear warranted to confirm these findings, assess possible explanations, and examine the circumstances in which premature menopause occurs.

Adult↗

PubMed1993

Assessment of the proposed Draft American National Standard method for evaluating the effectiveness of hearing conservation programs.

Using audiometric data, this study assessed the Draft American National Standard ANSI S12.13-1991 (DANS) method for evaluating the effectiveness of hearing conservation programs by comparing it against a standard epidemiologic method. Although the hearing conservation program of the study population was rated as "acceptable" (scale: acceptable, marginal, unacceptable) using the DANS method, the epidemiologic method found a 130% increased risk of hearing loss (relative risk = 2.3, 95% confidence interval = 0.8 to 6.5). In addition, study workers who were excluded from analyses for failing to comply with the DANS criteria were found to be at significantly increased risk of hearing loss (relative risk = 9.1, 95% confidence interval = 3.4 to 24.2). These data indicate that the DANS method may overestimate the effectiveness of hearing conservation programs and systematically exclude workers at high risk of hearing loss from analyses.

Adult↗

PubMed1993

An epidemiologic method for assessing the effectiveness of hearing conservation programs using audiometric data.

A hearing conservation program (HCP) must include audiometric monitoring. In keeping with this requirement, enormous bodies of audiometric data have been accumulated. However, only a limited number of methods are available for using audiometric data to assess HCP effectiveness. This study illustrates an epidemiologic method. The risk of developing hearing loss (measured by the standard threshold shift) was compared between study and reference populations using the risk ratio. The study population had an increased risk of nearly 3-fold. Epidemiologic risk comparison methods, using reference populations, offer an alternative to current methods for HCP evaluation using audiometric data.

Adult↗

PubMedDate not supplied

Biological, social, and behavioral factors associated with premenstrual syndrome.

OBJECTIVE: To investigate the influence of various biological, socioeconomic, and behavioral factors on premenstrual syndrome (PMS). DESIGN: Random-digit dialing technique. Of 7900 calls from all area codes, exchanges, and 2 digits known to be open in Virginia, with a pair of random digits, 1700 women were eligible for telephone interviews. A total of 874 women completed interviews, for a response rate of 67%. SETTING: State of Virginia. PATIENTS OR OTHER PARTICIPANTS: All women between the ages of 18 and 44 years and living in Virginia between August 1 and September 15, 1994, were eligible. MAIN OUTCOME MEASURES: Scores on Menstrual Distress Questionnaire, biological variables, lifestyle behaviors, socioeconomic status, and menstrual and reproductive history. RESULTS: Of the 874 women, 8.3% (95% confidence interval, 6.4%-10.2%) experienced PMS. Adjusted prevalence odds ratios for perceived stress and alcohol intake were 3.7 and 2.5, respectively, in women with PMS. Women with PMS were 2.9 times more likely to be physically active than women without PMS. Younger women, black women, and women with longer menses were more likely to have PMS. CONCLUSIONS: Scores on the stress scale and alcohol intake support the concept that PMS is stress related; intervention strategies to cope with stress may be effective. Further study will be required to determine the influence of race on PMS and whether women with PMS exercise more regularly than women without PMS because they believe exercise is effective in attenuating their symptoms.

Adult↗

PubMedDate not supplied

Time trends analysis of hearing loss: an alternative approach to evaluating hearing loss prevention programs.

Two general approaches for evaluating the performance of hearing loss prevention programs (HLPPs) are described in the literature: (1) a comparison of the rate of hearing loss in an HLPP with a reference population and (2) a comparison of audiometric variability or annual incidence of hearing loss with an established set of criteria that rank HLPP performance on a graded scale. This article discusses a third method, time trends analysis, which assesses patterns in hearing loss over time. Patterns may reflect program improvement (decreased hearing loss incidence over time), deterioration (a pattern of increased incidence), or stasis (unchanged incidence). To demonstrate this method, a time trends analysis was conducted on a population of 44,547 industrial workers. Subjects were divided into 11 subgroups based on year of enrollment in the HLPP (1980-1990) and followed retrospectively for 3 years to determine the incidence of hearing loss. Hazard ratios (HRs) were estimated for each subgroup by gender using the Cox Proportional Hazards model and adjusting for age, race, and hearing threshold at enrollment in the HLPP. For women, plots of adjusted HRs against enrollment years produced a statistically significant (p < 0.05) quadratic trend of an initial increase in hearing loss, followed by decreasing incidence over time. For men, there was a statistically significant linear trend of decreasing hearing loss over time. The downward trend, particularly during the late 1980s, indicates improved HLPP performance during the latter portion of the decade. Time trends analysis can be a valuable tool for assessing HLPP performance for those with access to follow-up data and ability to work with statistical models.

Adult↗

PubMedDate not supplied

Use of comparison populations for evaluating the effectiveness of hearing loss prevention programs.

One approach for evaluating the effectiveness of Hearing loss prevention programs (HLPPs) is to compare the rate of hearing loss in a study population with that in a reference population. This approach was used to evaluate the HLPP of a population of 14,900 employees of an industrial company with branches across the United States. Three reference populations were selected from a database of 22 industrial companies compiled under the sponsorship of the National Institute for Occupational Safety and Health. The risk of hearing loss in the study population was estimated relative to each of the three reference populations using the Cox proportional hazards model after adjustment for race, age at baseline, and hearing threshold at time of enrollment in the HLPP. In comparison with the three reference populations, hearing loss was 2.1 to 3.9 times more likely to occur in study population males and 1.8 to 5.1 times more likely in study population females. The 95% confidence interval around each risk estimate precluded unity, indicating that each risk estimate was statistically significant. These results indicate that the performance of the subject HLPP needs improvement. This study demonstrated the use of comparison populations for evaluating the effectiveness of HLPPs.

Adult↗