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PubMed1983

Effects of breastfeeding on IUD performance.

The effect that lactation might have on intrauterine device (IUD) performance was investigated by using data from a series of multicenter clinical trials. Life-table methods were applied to compare breastfeeding and non-breastfeeding women with respect to IUD expulsion, accidental pregnancy, IUD removal for various reasons, and overall continuation of IUD use. Results indicate that breastfeeding does not increase the risk of expulsion or other events, whether the device is inserted immediately (within ten minutes) or more than 42 days after delivery. (Am J Public Health 1983; 73:384-388.)

Age Factors↗

PubMed1983

Spontaneous abortions after the Three Mile Island nuclear accident: a life table analysis.

A study was conducted to determine whether the incidence of spontaneous abortion was greater than expected near the Three Mile Island (TMI) nuclear power plant during the months following the March 28, 1979 accident. All persons living within five miles of TMI were registered shortly after the accident, and information on pregnancy at the time of the accident was collected. After one year, all pregnancy cases were followed up and outcomes ascertained. Using the life table method, it was found that, given pregnancies after four completed weeks of gestation counting from the first day of the last menstrual period, the estimated incidence of spontaneous abortion (miscarriage before completion of 16 weeks of gestation) was 15.1 per cent for women pregnant at the time of the TMI accident. Combining spontaneous abortions and stillbirths (delivery of a dead fetus after 16 weeks of gestation), the estimated incidence was 16.1 per cent for pregnancies after four completed weeks of gestation. Both incidences are comparable to baseline studies of fetal loss.

Abortion, Spontaneous↗

PubMed1989

Survival analysis of hemophilia-associated AIDS cases in the US.

Using national hemophilia-associated AIDS (acquired immunodeficiency syndrome) surveillance data and the life table method of survival analysis, the median length of survival of hemophilic patients in the United States after the diagnosis of AIDS was 11.7 months; the cumulative probability of survival at one year was 49.2 +/- 2.0 percent; at two years, 28.9 +/- 2.3 percent. Patients 13-29 years of age at the time of diagnosis had the longest survival and those 60 years and older had the shortest. Patients diagnosed since 1986 survived longer than those diagnosed before 1986. Length of survival did not differ significantly by race, coagulation disorder, AIDS manifestation at the time of diagnosis, or region of residence. Seven patients survived more than 36 months after AIDS was diagnosed. These patients were similar to those surviving for a shorter duration except that they were more likely to have met only the 1987 revision of the Centers for Disease Control AIDS surveillance case definition (as opposed to the 1985 case definition). Results of this study suggest that survival among hemophilic patients after the diagnosis of AIDS is similar to that reported by other investigators for other AIDS risk groups, excluding patients with Kaposi's sarcoma.

Acquired Immunodeficiency Syndrome↗

PubMed2003

[Prognostic factors in resectable non-small-cell bronchial carcinoma].

This study represents the univariate and multivariate analysis of prognostic factors of resectable non small cell-lung cancer (NSCLC) that included 360 patients who underwent a surgical treatment because of primary (NSCLC) in the aforementioned institution in a period between 1985 and 1992. Patients with incomplete resection were rejected, perioperative deaths were not included in the analysis. In the analysed group there were 2931 (81.38%) males and 67(18.62%) females--M:F ratio 4.37:1. Age of the operated patients was 36-75 years with the mean age of 55.15 years. Right-sided tumours existed in 197(54.72%) patients, left-sided tumours in 163(45.28%) patients. Based on pTNM, 157, 65, 114, 18 and 6 patients were classified into stages I, II, IIIA, IIIB and IV respectively. In the univariate analysis, survival curves were obtained using the life table method, with the statistical analysis of the obtained data using the Gehan-Wilcoxon method. In the multivariate analysis--Cox regression analysis was performed. Multivariate analysis found only T-stage, N-stage and the stage of the disease as significant independent prognostic factors. Mode of influence of factors that were found significant in the univariate analysis (age 60 years, tumour diameter 60 mm, involvement of the visceral pleura, indirect tumour signs) is discussed and compared with literature data. Survival differences depending on other factors (tumour location, bronchoscopic aspect, extent of the resection), although without statistical significance, can be useful for the clinician, in the same time contributing to the better comprehension of informations obtained by basical investigations, especially of lymphatic spread of the disease and tumour pathology.

Adult↗

PubMed1995

Unchanged incidence of diabetic nephropathy in IDDM patients.

Recently, a dramatic decline in the cumulative incidence of diabetic nephropathy (< 10% after 25 years of diabetes) has been reported in insulin-dependent diabetes mellitus (IDDM) patients diagnosed before the age of 15 years between 1961 and 1980. In a clinic-based study, we assessed recent trends in the incidence of diabetic nephropathy. All 356 patients in whom IDDM was diagnosed before the age of 41 years between 1965 and 1979, identified in 1984, were followed until 1991 or until death. All patients were Caucasians and resided in Copenhagen. The cumulative incidences (life-table method) of diabetic nephropathy (urinary albumin excretion > or = 300 mg/24 h in two out of three consecutive samples) after 15 years of diabetes and in 1991 were 18 +/- 4 and 35 +/- 5% (cumulative incidence +/- SE; onset of diabetes 1965-1969, n = 113), 20 +/- 4 and 35 +/- 5% (onset of diabetes 1970-1974, n = 130), and 16 +/- 5% (onset of diabetes 1975-1979, n = 113), respectively (NS at 15 years). The prevalence of persistent microalbuminuria (31-299 mg/24 h) at time of follow-up was 24% (95% confidence interval: 16-33) in the group with onset of diabetes in 1965-1969, 28% (20-36) with onset of diabetes in 1970-1974, and 19% (13-28) with onset of diabetes in 1975-1979 (NS). The mean +/- SE HbA1c measured yearly beginning in 1984 was higher in patients with nephropathy (9.4 +/- 0.1%) and persistent microalbuminuria (8.9 +/- 0.1%) than in patients with normoalbuminuria (8.5 +/- 0.1%; P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

A cohort study of mortality in two clinic populations of patients with diabetes mellitus.

Mortality rates of two cohorts of patients with diabetes mellitus are estimated and compared. The Atlanta cohort is defined as all black patients receiving care at the diabetes clinic of Grady Memorial Hospital for the first time during calendar year 1971. The Memphis cohort is defined as all black patients referred from the City of Memphis Hospital outpatient clinic to a decentralized neighborhood clinic operated by the Memphis and Shelby County Health Department during September 1969 through August 1970. The Atlanta program discontinued all prescriptions of oral hypoglycemic drugs and emphasized instead an aggressive diet therapy. The Memphis program has used diet therapy but also insulin and/or oral hypoglycemic agents according to current guidelines. The ratios of observed to expected deaths (standardized mortality ratios) were remarkably similar for the two cohorts. In both cohorts the standardized mortality ratios were greatest for the youngest patients and for those patients whose duration of illness was longest. Nine-year survival rates, estimated by the life-table method and adjusted for differences in frequency distributions of entry age and duration of diabetes, were also similar for the two cohorts.

Actuarial Analysis↗

PubMed2004

Standardized indices of mortality among persons with spinal cord injury: accelerated aging process.

We conducted this study to compare survival rates and morbidity of persons with spinal cord injury (SCI) versus general population, and to clarify the risk of SCI persons. The subjects of this study were 960 men with SCI who had been accommodated in the eight Labor Accident Rehabilitation Centers in Japan during the period of 1965-1995. The surveyed items were the year of birth, the year of injury, level of spinal cord injury and survival status. The classification of cause of death was taken from ICD-10. The cumulative survival rate by life table method was calculated. In order to compare the risks of each cause of death in SCI persons with general population, cause-specific standardized mortality ratio (SMR) was examined. The leading cause of death was malignant neoplasms at 28 persons, and SMR (general population=100) was 184, followed by the circulatory system disease, external cause (including suicide) and the genitourinary system disease. In the subgroups of malignant neoplasms, the SMR was 6,619 for cutaneous carcinomas and 1,482 for bladder carcinomas (p<0.01). Thus aging-related diseases which had close correlation with lifestyle and environment were the major cause of deaths in SCI persons.

Adolescent↗

PubMed1994

Clinical course of patients with primary nasal polyps.

A follow-up study on 180 patients treated for the first time for nasal polyps was performed. The follow-up period was from 1 to 8 years with a median of 57 months. The majority of patients had postoperative topical steroid treatment. 65.6% of patients had one polypectomy, 17.8% had two polypectomies, 10% had 3, 2.8% had 4, and 3.9% of patients had 5-10 polypectomies performed during the follow-up period. Patients without asthma, acute recurrent or chronic sinusitis, acetylsalicylic acid intolerance, or allergy had fewer polypectomies and less topical steroid treatment than patients with these characteristics. The recurrence profile between the first and second polypectomy described with the life-table method showed a slow decline in the number of patients with only one polypectomy. The time span needed before significant clinical symptoms occurred after the first polypectomy indicates that not all primary polyp patients are prone to recurrence. Nasal polyps is probably a manifestation of different clinical and aetio-pathogenetic entities. Further identification of such entities is needed to improve treatment strategy.

Adolescent↗

PubMed1977

Prognosis of medically treated gastric ulcer. A prospective endoscopic study.

During the study period 1972-74 gastric ulcer was demonstrated by endoscopy in 114 patients, 54 of whom were included in the present study. Forty-two were excluded because of ulcer showing incipient healing, superficial erosions, manifest or suspected malignancy, or indication for surgery. Eighteen patients were not included because of advanced age, complicating diseases, or refusal to have further examinations. The study comprises a treatment phase and a follow-up phase. The treatment phase ran from the first encoscopic demonstration of gastric ulcer until complete healing. During this period the patient was treated with antacids and anticholinergics and, if required by his condition, admission to hospital. During the treatment phase, endoscopy was performed at intervals of from 3 to 6 weeks until healing. During the follow-up phase endoscopy was carried out in the event of dyspeptic complaints that might indicate recurrent ulcer. The healing and recurrence rates for various periods were calculated by the aid of the life-table method. After 1 mo. of treatment 13% of the aptients exhibited healing, after 2 mo. 29%, after 3 mo. 41%, and after 12 mo. 79%. In one month 9% of the primarily healed ulcers had recurred, in 2 mo. 15%, in 3 mo. 22%, and in 12 mo. 43%. The healing rate is appreciably lower than results reported in the literature, whereas the recurrence rate is in closer accordance with previous studies.

Adult↗

PubMed1986

Prevention of relapse with various antiulcer drugs.

The relative value of maintenance therapy with cimetidine, ranitidine, pirenzepine, and antacids only (when used for symptomatic relief) has been evaluated in 205 patients with a subsequent follow-up period of 2 years. The patients had a completely healed duodenal ulcer after 8 weeks of treatment and were then randomly allocated to four groups, which were as follows: group 1: 60 patients treated with 400 mg cimetidine at night; group 2: 55 patients treated with 150 mg ranitidine at night; group 3: 50 patients treated with 50 mg pirenzepine at night; and group 4: 40 patients treated only with antacids as needed for symptomatic relief. Endoscopy was repeated after 6, 12, 18, and 24 months of treatment, and whenever symptoms suggested recurrence. Although the number of dropouts was high (27 in group 1, 20 in group 2, 18 in group 3 and 12 in group 4), statistical analysis by the life-table method showed that cimetidine, ranitidine, and pirenzepine had similar therapeutic value. After 1 and 2 years the relapse rate of duodenal ulcer was 17.5% and 43.6% respectively, for cimetidine, 21% and 69.3% for ranitidine, 21.7 and 50.2% for pirenzepine, and 49.8% and 77.7% for antacids. The incidence of erosions was lower in those groups with the higher ulcer relapse rate, a point discussed in the present study.

Adult↗

PubMed1987

Prognosis and mortality of ulcerative colitis in Stockholm County, 1955-1979.

All 1274 patients in Stockholm County who were diagnosed as having ulcerative colitis during the 25-year period 1955-79 were followed up and studied with regard to prognosis and mortality. There were 109 deaths recorded--41 caused by ulcerative colitis and 68 from other causes. The cumulative survival probability (computed by life-table methods) was worse than expected. For males it was approximately 80% at 20 years, to be compared with the approximately 97% expected in the background population. For females the corresponding figures were approximately 85% and 98%, respectively. The excess death risk increased with increasing age and was more commonly due to unrelated causes than to ulcerative colitis as such. In patients with total colitis at onset the death risk was greater than for other patients during the first years of disease. Thereafter the prognosis was, if anything, better than in other cases. There was no major change in postoperative mortality or general mortality pattern during the 25 years of observation.

Adolescent↗

PubMed1987

The risk of colorectal cancer in ulcerative colitis. An epidemiologic study.

Patients with a definite diagnosis of ulcerative colitis in Stockholm County during the 35-year period 1945-79 were identified and followed up with regard to the development of cancer of the colon. We found 25 patients who had developed 31 cancers. In 24 of 25 cases this occurred in patients with total colitis. The cumulative risk of developing cancer for patients with total colitis at follow-up study was calculated by means of life-table methods. It was 13% at 25 years (SD +/- 4.2%) among patients diagnosed in 1945-79, compared with the 1.9% expected in a population matched for age and sex. Among patients diagnosed in 1955-79 the risk was approximately 5% at 20 years (SD +/- 3.0%), compared with 1.4% for the background population. The cancer risk for all patients with colitis was higher but not significantly higher than that of the general population. The outcome of patients who developed cancer was dependent on histologic staging (Dukes's) at surgery but not on age at cancer diagnosis.

Adult↗

PubMed1987

Nizatidine versus ranitidine in the prevention of duodenal ulcer relapse. Six-month interim results of a European multicentre study.

Nizatidine, a new H2-receptor antagonist, was compared with ranitidine in a double-blind, randomized, multicentre trial for the prevention of duodenal ulcer relapse. This is the interim analysis of 197 patients admitted to the study by 1 September 1985, having finished a 6-month treatment period by 1 March 1986. At night, 96 and 101 patients received 150 mg nizatidine and 150 mg ranitidine, respectively. Both groups were well matched for demographic data, duration and severity of ulcer disease. Calculating cumulative relapse rates by the life-table method of Cutler and Ederer, 18% on nizatidine and 13% on ranitidine had experienced a symptomatic or asymptomatic recurrence. The difference is not statistically significant. The symptomatic response was identical in both groups, 3/4 of the patients in both groups being free of any symptom over all 6 months. During maintenance treatment, 24% of the patients on nizatidine and 32% of those on ranitidine reported new symptoms, listed as 'adverse events'. However, none of these events was likely to be drug related. There was no difference between the two groups concerning the percentage change of laboratory variables from baseline to endpoint.

Adult↗

PubMed1990

Blood analyses as prognostic factors in primary lung cancer.

The prognostic value of some pretreatment blood tests was analysed in a follow-up study of 189 patients with non-small cell lung cancer diagnosed in West-Norway between 1976 and 1985. At diagnosis 100 patients had stage III/IV disease. Five-year survival calculated with the life-table method was 12%. In univariate survival analyses significant prognostic factors were stage III/IV disease, weight loss, elevated lactate dehydrogenase, gamma glutamyl transferase, erythrocyte sedimentation rate and alkaline phosphatase, thrombocytosis, leukocytosis and anaemia. In multivariate survival analyses with the Cox's regression model stage III/IV disease, elevated lactate dehydrogenase, thrombocytes and erythrocyte sedimentation rate were significant prognostic factors. It is concluded that these blood analyses at diagnosis in non-small cell lung cancer patients may give additional prognostic information. The need for multivariate analyses is also demonstrated.

Adult↗

PubMed1997

Prognostic significance of the CD10+CD19+CD34+ B-progenitor immunophenotype in children with acute lymphoblastic leukemia: a report from the Children's Cancer Group.

Leukemic cells from most patients with B-lineage acute lymphoblastic leukemia (ALL) appear to originate from normal B-lymphocyte precursors. The earliest B-cell progenitors coexpress the antigens CD10, CD19, or CD34 on their cell surfaces. In a large cohort of 2028 children with ALL, we compared treatment outcomes of a subset of B-lineage ALL patients with CD10+CD19+CD34+ immature B-progenitor leukemia (BPL) to the treatment outcomes of the remaining CD19+ B-lineage ALL patients. Pediatric B-lineage ALL cases enrolled on risk-adjusted ALL treatment protocols of the Children's Cancer Group were immunophenotypically classified as BPL or non-BPL. Patients were stratified further into age groups of > or = 1 year and <12 months. Event-free survival (EFS) outcomes were calculated by standard life table methods. BPL patients in both age groups generally had more favorable presenting characteristics than non-BPL controls. Within the age group of > or = 1 year, BPL patients had a slightly better EFS outcome than non-BPL patients, with 3-year estimates of 83.9% (SD = 1.1%) vs. 78.8% (SD = 1.8%), respectively (P = 0.10). Infants with BPL, representing one-fifth of the total infant patient population, had a significantly better EFS outcome than infants with non-BPL (three-year EFS: 82.4%, SD = 9.2% vs. 34.4%, SD = 5.9%, P = 0.006). In univariate analyses, the relative hazard rate (RHR) was 3.73 for non-BPL vs BPL and this marked difference in EFS outcome was maintained at 5 years of follow-up. The favorable prognostic influence of the BPL immunophenotype for infants remained significant in multivariate analyses with an RHR of 2.72 for non-BPL vs BPL (P = 0.05). CD10+CD19+CD34+ immature B-progenitor immunophenotype is associated with favorable characteristics for children with ALL and identifies a subset of infants who achieve favorable EFS outcomes.

Adult↗

PubMed1987

The risk of rebleeding from ruptured intracranial aneurysms.

In the 5-year period from 1978 to 1983, 1076 patients with ruptured intracranial aneurysms were admitted to the six neurosurgical departments in Denmark and were entered in a prospective consecutive study conducted by the Danish Aneurysm Study Group. The patients were followed with 3-month and 2-year examinations or to death. A total of 133 patients suffered at least one rebleed after their initial hemorrhage during their first stay in the neurosurgical department; these patients had a mortality rate of 80% compared to 41% for patients without a rebleed (p less than 0.0001). During the first 2 weeks after the initial insult, 102 rebleeds were registered. The daily rate of rebleeds during these 2 weeks, calculated using a life-table method, varied from 0.2% to 2.1%. The rebleed rate during the first 24 hours (Day 0) was 0.8%, and the maximum risk of rebleeding was observed between Day 4 and Day 9. Significantly fewer rebleeds were reported in patients with good clinical grades (Grades 1 to 3, Hunt Grades I and II) compared to those with poor clinical grades (Grades 4 to 9, Hunt Grades III to V: p less than 0.001).

Adolescent↗

PubMed1988

Function of parietal and frontal shunts in childhood hydrocephalus.

This study was performed to determine if cerebrospinal fluid (CSF) shunts inserted via the frontal and parietal regions function for similar lengths of time. The medical records of 114 children with CSF shunts were reviewed. In 83 of these cases computerized tomography scans were also available. Ninety percent of the operations were to insert the child's first shunt. The site of insertion, cause of hydrocephalus, patient's age, surgeon, duration of function (time from insertion to malfunction or to latest follow-up evaluation), presence of infection, catheter location within the ventricle, and duration of function of the subsequent shunt were recorded. Data were analyzed by the chi-square, logistic regression, and life-table methods. Shunts had been inserted via the frontal route in 62 children and via the parietal route in 52. The children's ages, causes of hydrocephalus, and infection rates were similar in both groups. Duration of shunt function was predicted by the site of shunt insertion and the catheter position within the ventricles: shunts inserted via the frontal region functioned significantly longer than parietally inserted shunts, both as the initial shunt (Wilcoxon, p = 0.0008) and after a malfunction, and catheters positioned within the ipsilateral frontal horn functioned significantly longer than those in other ventricular locations (Wilcoxon, p = 0.03).

Age Factors↗

PubMedDate not supplied

Twenty-year follow-up of the breast cancers diagnosed during the Breast Cancer Detection Demonstration Project.

This study reports on the 20-year follow-up of the women diagnosed with breast cancer in the Breast Cancer Detection Demonstration Project (BCDDP) between 1973 and 1980. This project provided 5 years of screening with physical examination and two-view mammography for 280,000 volunteer women across the United States. Based on a 96% follow-up from 1993 to 1995 of the 4,051 women with breast cancer available for analysis, 2,658 (66%) were alive and 1,393 (34%) were dead. A high proportion of the cancers were detected by mammography alone, and 28.6% of all the cancers were smaller than 1.0 cm. Survival rates were calculated by life table method with deaths from breast cancer as the outcome. The adjusted survival rate for the entire group was 80.5%, and the observed survival rate was 61.7%. Adjusted and observed survival rates were 97.2% and 78.5%, respectively, for women with non-invasive cancers and 78.2% and 59.3%, respectively, for those with invasive cancers. Lymph node status and the size of the cancer at diagnosis were prognostic indicators of survival in the BCDDP Women with invasive cancers and negative lymph nodes had an 85.5% breast cancer survival rate and a 65.6% observed survival rate. Adjusted survival rates for women with invasive breast cancers were 90.2% for cancers smaller than 1 cm, 80.5%, for cancers 1.0 to 1.9 cm, 70.5% for cancers 2.0 to 4.9 cm, and 60.6% for cancers larger than 5 cm. Women 40 to 49 years of age demonstrated a greater survival with noninvasive or invasive cancers smaller than 5.0 cm compared with women 50 to 59 and 60 to 69 years of age at diagnosis. These results from the BCDDP are discussed in the context of the recent decline in breast cancer incidence and mortality in the United States.

Adult↗