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At least 145 records · Page 8Linked to original sources
PubMed1980

Second malignancies in Hodgkin's disease: a complication of certain forms of treatment.

A total of 764 patients with Hodgkin's disease treated with radiotherapy (RT) or chemotherapy or both were reviewed 3-186 months (median 43 months) after initial treatment to assess the incidence of second malignancies. Incidence of solid tumours and acute non-lymphoblastic leukaemia (ANLL) were calculated by a life-table method and percentages of patients affected derived from life-table plots. Within 10 years after initial treatment the overall incidence of second solid tumours was 7.3%, and over a comparable period 2.4% of patients developed ANLL. Solid tumours occurred only in patients given RT with or without adjuvant chemotherapy, and ANLL occurred only after treatment with MOPP (mustine, vincristine, procarbazine, and prednisolone) or modified MOPP regimens. Neither solid tumours nor ANLL occurred in patients given ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine). The highest incidence of leukaemia (5.4%) occurred after treatment with extensive RT plus (5.4%) occurred after treatment with extensive RT plus MOPP; hence the benefits of this approach in Hodgkin's disease must be weighed against its carcinogenic potential.

Adult↗
PubMed1994

Premorbid diet and the prognosis of women with breast cancer.

BACKGROUND: Consumption of a high-fat diet has been associated with poor survival in breast cancer patients. However, studies examining this association are limited and have not used adjustment of energy in their estimates. PURPOSE: The effect of usual diet before diagnosis of breast cancer on the risk of dying of breast cancer was examined in a cohort of women with breast cancer from the National Breast Screening Study (NBSS) in Canada. METHODS: From a cohort of 89,835 women in the NBSS, a total of 1270 histologically confirmed cases of invasive carcinoma of the breast were identified by active follow-up, supplemented by passive follow-up involving record linkage to provincial cancer registries. Of these, 678 case patients who had completed a diet history and were diagnosed from January 1982 up to June 1992 formed the cohort for this investigation. Diet was ascertained from a self-administered diet-history questionnaire. Mortality data were obtained by linkage to the Canadian Mortality Data Base of Statistics Canada, provincial cancer registries, and annual follow-up of cases through physicians. Risk of dying and survival probabilities were estimated by the Cox proportional hazards method and the actuarial life-table method. RESULTS: There were 83 deaths in this study cohort of 678 women; 76 deaths were due to breast cancer, and the remaining seven resulted from other causes. The 5-year survival rate was 90%. For every 5% increase in energy from saturated fat, the risk of dying of breast cancer increased by 50% (hazard ratio = 1.50; 95% confidence interval [CI]: 1.08-2.08). No significant increase in risk was seen with total fat intake (hazard ratio = 1.21; 95% CI = 0.91-1.61) or oleic acid intake (hazard ratio = 1.25; 95% CI = 0.90-1.74). There was a lower risk of dying of breast cancer in the highest quartiles of beta carotene intake (hazard ratio = 0.48; 95% CI = 0.23-0.99) and vitamin C intake (hazard ratio = 0.43; 95% CI: 0.21-0.86); both vitamins showed a significant dose-response relationship (P for trend, < or = .05). These effects varied with menopausal status at diagnosis and tumor characteristics. CONCLUSIONS: These results suggest an increased risk of dying of breast cancer with higher intakes of saturated fat before diagnosis and slightly reduced risk with higher intakes of beta carotene and vitamin C. IMPLICATIONS: More attention should be paid to premorbid dietary habits in relation to breast cancer prognosis. Further studies, however, need to be done with full ascertainment of dietary changes prior to and subsequent to diagnosis.

Adult↗
PubMed1992

Late relapse and mortality in stage I large bowel cancer.

The outcome was determined for patients with Stage I cancers of the large bowel (colon, rectum, and anus) who were treated from 1982-1989. In 119 consecutive patients, the 5-year survival was approximately 70% (72% by the absolute direct method; 67% by the actuarial life table method). Although the overall 5-year survival was similar to numerous other published reports, it was disturbing to observe that 41% of the living patients had relapsed. Furthermore, although 88/119 (67%) were alive at last report, 2-7 years after treatment, only 23 (19%) were believed to be free of cancer. We conclude that follow-up for more than 5 years and the assessment of disease-free survival are required to evaluate the outcome from Stage I large bowel cancer.

Actuarial Analysis↗
PubMed2000

Use of the intrauterine device: efficacy and safety.

OBJECTIVES: To characterize the family planning center population that used an intrauterine device (IUD), to compare the reasons for its removal and types of incidents encountered by nulliparous women and women with children, and to evaluate the efficacy and safety of this method by the use of life tables. METHOD: This was an observational, descriptive, prospective study of 774 women, recruited over a 5-year period, who used an IUD by informed choice, presented no absolute contraindications and were assessed throughout the whole follow-up period. RESULTS: The mean age (standard deviation) of IUD use was 32.8 (5.9) years for non-nulliparous women and 27.4 (5.3) years for nulliparous women (p < 0.001). Follow-up was completed at the family planning center for 80.1% of women. No differences were observed between nulliparous and non-nulliparous women with respect to accidental pregnancy, suspected pelvic inflammatory disease or expulsion. Non-nulliparous women experienced more major bleeding incidents and anemia (p = 0.010). All pregnancies occurred with low-load devices. Nulliparous women discontinued IUD use more often due to a desire to become pregnant (p = 0.009) and suffered more vulvovaginal infections (p = 0.044). CONCLUSIONS: The IUD is a safe contraceptive option regardless of parity, provided that women are carefully selected.

Adult↗
PubMed2003

Intracordal injection of autologous fat in patients with unilateral laryngeal nerve paralysis: long-term results from the patient's perspective.

OBJECTIVE: Based on 80 patients with a previously nonsurgically treated unilateral laryngeal nerve paralysis (ULNP) and according to the patient's self-assessment, the authors document the long-term results achieved with the intracordal injection of autologous fat. STUDY DESIGN: Retrospective series, inception cohort. METHODS: Kaplan-Meier actuarial life table method and univariate analysis. RESULTS: None of the 80 patients died in the immediate postoperative period. Morbidity included hematoma at the donor site (in three patients), development of an intracordal cyst at the injection site (in three patients), fat extrusion at the injection site (in one patient), and temporary tracheotomy (in one patient). The initial and ultimate overall success rates were 96.2% and 77.2%, respectively. In univariate analysis, none of the variables under analysis (gender, age, associated neurological lesions, associated pneumonectomy, associated neoplasia, cause of the ULNP, side of the ULNP, nerve involved, delay between the onset of the ULNP and the intracordal injection, severity of the symptoms, mode of harvesting the autologous fat, and surgeon who performed the injection) was statistically related to the ultimate outcome after the intracordal injection of autologous fat. Among the group of 45 patients in whom the intracordal injection was initially considered to be successful with no further recovery of motion of the true vocal cord and a minimum survival of 12 months, the ultimate overall success rate was 62.2%, and the 3-month, 6-month, and 12-month Kaplan-Meier actuarial estimates for success were 91.1%, 72.8%, and 63.1%, respectively. CONCLUSIONS: In the present study, data confirm that the intracordal injection of autologous fat is a useful and safe procedure in patients with ULNP. However, the impossibility of exactly predicting the amount of resorption of the injected fat and the lack of predictability of the duration of the results, together with the good and stable results achieved at the authors' department with the medialization thyroplasty led the authors to reduce its current use.

Adipose Tissue↗
PubMed1982

Pregnancy rates during long-term use of copper IUDs.

990 cases of women using standard copper IUDs (Cu 7; Cu T; Multiload) up to a maximum period of 8 years have been analyzed statistically. The long-term use effectiveness was evaluated mainly by using statistical methods (life table). Pregnancy rates decreased during the whole period of observation but more evidently after 2 years of use. It is recommended that medicated IUDs, free of side effects, be exchanged only after 5 years of use, corrosive changes being not too far advanced after this period. New IUD models are less likely to be subject to corrosion and will therefore need to be replaced less frequently.

Age Factors↗
PubMed1988

A comparative clinical trial of Norinyl 1/35 versus Brevicon in Rio Clara, Brazil.

A comparative clinical trial of two combined oral contraceptives (OCs) with equivalent estrogen content, but different amounts of progestogens, was conducted at the Centro Medico Especializado em Planejamento Familiar in Rio Clara, Brazil. The study was designed to determine the differences in discontinuation rates between Norinyl 1/35 (Syntex) and Brevicon (Syntex) as well as the frequency of selected side effects which might contribute to method discontinuation. Both OCs contain 0.035 mg of ethinyl estradiol; Brevicon contains 0.5 mg and Norinyl 1/35 contains 1 mg norethindrone. Three-hundred women enrolled in the study were randomly assigned to either the Norinyl 1/35 or Brevicon OCs and follow-up visits were scheduled at 1, 4, 8 and 12 months after admission. Intermenstrual bleeding was reported by significantly more women in the Brevicon group than in the Norinyl group (p less than 0.05), and significantly more Brevicon users reported an increase in intermenstrual bleeding. At the end of the study period, no differences were found between the two OC groups in terms of discontinuation rates, but a large number of women in each group discontinued for menstrual problems. The total discontinuation rates at 11 months for both groups were extremely high: 68.2 for the Norinyl 1/35 group and 75.2 for the Brevicon users. The largest group of discontinuations were comprised of those discontinuing for menstrual problems, other personal reasons, planned pregnancy and side effects.

Adult↗
PubMed1999

Personal hormone monitoring for contraception.

OBJECTIVE: To determine the effectiveness and acceptability of personal hormone monitoring for contraception. DESIGN: A large prospective study was carried out on personal hormone monitoring for contraception when used with abstinence during the identified fertile days. SETTING: Three country study under the auspices of the departments of Obstetrics and Gynaecology of the Universities of Birmingham, Dublin and Dusseldorf SUBJECTS: Seven hundred and ten women, median age 30, were recruited from the general population. They were required to have regular menstrual cycles (23-35 days) and to be delaying their next pregnancy. INTERVENTIONS: Personal hormone monitoring consists of a hand held monitor and disposable test sticks which measure changes in urinary concentrations of oestrone-3-glucuronide and luteinising hormone. An algorithm estimated the fertile days which were displayed by a red light. OUTCOME MEASURES AND RESULTS: One hundred and sixty two pregnancies occurred in 7209 cycles of use, of which 67 were method related pregnancies. The 13 cycle life-table method pregnancy rate (95 per cent CI) was 12. 1 per cent (9.3-14.8). The system allowed analysis of the effect of changes to the algorithm to modify the defined fertile period. As a result the algorithm was changed to increase the median warning of the luteinising hormone surge to six days. With the revised algorithm, half of the method pregnancies would have been prevented giving a calculated method pregnancy rate of 6.2 per cent (4.2-8.3) and method efficacy of 93.8 per cent. The continuation rate after 13 cycles was 78 per cent. CONCLUSION: Personal hormone monitoring proved simple to use and will be of value to women who do not want to use other methods of contraception.

Adolescent↗
PubMed1992

Contraceptive efficacy of lactational amenorrhoea.

Pregnancy is rare among breastfeeding women with lactational amenorrhoea. The lactational amenorrhoea method (LAM) is the informed use of breastfeeding as a contraceptive method by a woman who is still amenorrhoeic, and who is not feeding her baby with supplements, for up to 6 months after delivery. Under these three conditions, LAM users are thought to have 98% protection from pregnancy. It can be difficult, however, to determine when supplementation of the baby's diet begins. We have analysed data from nine studies of the recovery of fertility in breastfeeding women to assess the effectiveness of lactational amenorrhoea alone, irrespective of whether supplements have been introduced, as a fertility regulation method post partum. Cumulative probabilities of ovulation during lactational amenorrhoea were 30.9 and 67.3 per 100 women at 6 and 12 months, respectively, compared with 27.2 at 6 months when all three criteria of the LAM were met. Cumulative pregnancy rates during lactational amenorrhoea were 2.9 and 5.9 per 100 women at 6 and 12 months, compared with 0.7 at 6 months for the LAM. The probability of pregnancy during lactational amenorrhoea calculated from these studies is similar to that of other modern contraceptive methods, and it seems reasonable for a woman to rely on lactational amenorrhoea without regard to whether she is fully or partly breastfeeding. So that amenorrhoea and fertility suppression can be maintained, counselling about good breastfeeding and weaning practices remains important.

Actuarial Analysis↗
PubMed1979

Immediate postpartum insertion of a copper-wired intrauterine contraceptive device, the MLCu250.

The MLCu250, a copper-wired intrauterine contraceptive device, was inserted in 600 women immediately after delivery of the placenta. Thirty months after insertion, 9843 woman months of experience were computerized and the data analysed according to the life-table method. The gross cumulative pregnancy and expulsion rates were 1.3 and 6.0 respectively. No serious complications were observed and the puerperium was uncomplicated.

Adult↗
PubMed1996

Family and fertility careers of Polish females: a semi-parametric and life table approach.

"In this paper an evaluation has been made using the semi-parametric analysis and life table method of changes in the process of formation and dissolution of families in Poland, and changes in fertility careers by cohorts. An answer was sought to the following questions: What are the factors significantly determining the process studied? What differences appear between cohorts?"

Cohort Studies↗
PubMed1997

Invasive cervical cancer after conservative therapy for cervical intraepithelial neoplasia.

BACKGROUND: Conservative outpatient therapy for cervical intraepithelial neoplasia (CIN) by ablative or excisional techniques is widely used. The main objective of this treatment is the prevention of invasive cervical cancer. We assessed the rate of invasive disease and the duration of the risk of developing invasive cervical cancer after such treatment. METHODS: Four UK centres have used life-table methods to analyse the long-term results of conservative treatment of CIN. We combined and updated data from these studies to investigate the rate of invasive disease after treatment and the duration of that risk. FINDINGS: The data comprised 44 699 woman-years of follow-up, with 2116 women under observation 8 years after treatment. 33 women developed invasive cancer, 14 of whom had microinvasion. The cumulative rate of invasion 8 years after treatment was 5.8 per 1000 women and the rate of invasive cancer during this period was 85 (95% CI 60-119) per 100,000 woman-years. The risk of developing cancer did not change throughout the 8 years of follow-up. INTERPRETATION: These data show that conservative outpatient therapy in women with CIN reduces the risk of invasive cancer of the cervix by 95% during the first 8 years after treatment. However, even with careful, long-term follow-up, the risk of invasive cervical cancer among these women is about five times greater than that among the general population of women throughout that period. Careful follow-up is essential for at least 10 years after conservative treatment of CIN.

Adult↗
PubMed1992

Worldwide variations in the lifetime probability of reproductive cancer in women: implications of best-case, worst-case, and likely-case assumptions about the effect of oral contraceptive use.

Cancer incidence in countries representative of three patterns of reproductive cancer and age-specific mortality was used to estimate the effect of oral contraceptive use on the lifetime probability of reproductive cancer under three sets of assumptions about the effects of oral contraceptives. Under the set of assumptions considered likely, oral contraceptives were estimated to reduce or increase only slightly the lifetime probability of any reproductive cancer in each setting. Under worst-case assumptions, oral contraceptives were estimated to increase the lifetime probability of reproductive cancer only modestly in settings with low cancer rates and in settings with high rates of breast, ovarian, and endometrial cancer, but it might have a large impact on lifetime probability of reproductive cancer in settings with high cervical cancer rates. Under best-case assumptions, oral contraceptives were estimated to decrease the lifetime probability of reproductive cancer in each setting; this reduction was estimated to be greatest in settings where endometrial and ovarian cancer incidence are high.

Adolescent↗
PubMed1992

Should women with familial ovarian cancer undergo prophylactic oophorectomy?

OBJECTIVES: To estimate the lifetime probabilities of ovarian cancer in women from families with hereditary ovarian cancer syndromes and those with a family history of ovarian cancer, and to assess the needs for prevention and surveillance in such women. DATA SOURCES: We searched for studies of familial ovarian cancer published since 1966 and used ovarian cancer incidence data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute. METHODS: Pooled estimates of relative risk of ovarian cancer among women with a family history of ovarian cancer were derived using statistical methods based on fixed effects. Modified life-table methods were used to estimate the lifetime probability of ovarian cancer. DATA SYNTHESIS: The lifetime probability of ovarian cancer increases from about 1.6% in a 35-year-old woman without a family history of ovarian cancer to about 5% if she has one relative and 7% if she has two relatives with ovarian cancer. The lifetime probability may decrease to about 3-4% if she takes oral contraceptives for 5-9 years. Women from families with hereditary ovarian cancer syndromes may have as high as a 50% lifetime risk of ovarian cancer. CONCLUSIONS: The risk of ovarian cancer in women from families with hereditary ovarian cancer syndromes is sufficiently high to warrant prophylactic oophorectomy. Among women with one relative with ovarian cancer, the lifetime probability of ovarian cancer is not high enough to recommend oophorectomy. However, some women may choose oophorectomy depending on their attitudes concerning risk-taking, surgery, and hormone replacement. Oral contraceptives should be considered as preventive therapy to decrease the risk of ovarian cancer in women with a family history of ovarian cancer.

Adult↗
PubMed1986

Five years' experience with levonorgestrel-releasing IUDs.

Two levonorgestrel-releasing IUDs and a copper-releasing IUD of the same shape were studied in a randomized comparative study over five years. The levonorgestrel-releasing IUDs released 20 micrograms or 30 micrograms per day. The Pearl index during the 10,600 woman-months of LNG-IUD use was 0.11. The control device releasing copper had a Pearl index of 1.6. The amount and duration of menstrual bleeding was greatly reduced, leading to a high incidence of oligo- or amenorrhea. The continuation rate in this pioneer trial was 53 per 100 users for the levonorgestrel-releasing IUD (LNG-IUDs) and 50 per 100 users for the copper-releasing IUD (Nova T). The removal rates for reasons other than amenorrhea were not significantly different. Discontinuation because of amenorrhea occurred during the first two years, the cumulative termination rate for this reason was 11.6 per 100 users at five years. The LNG-IUDs removed for investigation after five years of use revealed that the devices contained about 40 percent of the original load. The effective lifespan of the device has been demonstrated by this study to be five years; the residual steroid gives an additional safety period of two more years. The LNG-IUD is a highly effective reversible contraceptive method, which strongly reduced the amount and duration of bleeding. During the first two months there is scanty but frequent spotting which, like the high incidence of oligo- and/or amenorrhea, requires counselling of health personnel and women using LNG-IUDs.

Adult↗
PubMedDate not supplied

Analysis of underlying and multiple-cause mortality data.

"A variety of life table models were used for the analysis of the (1984-86) Kuwaiti cause-specific mortality data. These models comprised total mortality, multiple-decrement, cause-elimination, cause-delay and disease dependency. The models were illustrated by application to a set of four chronic diseases: hypertensive, ischaemic heart, cerebrovascular and diabetes mellitus. The life table methods quantify the relative weights of different diseases as hazards to mortality after adjustment for other causes. They can also evaluate the extent of dependency between underlying cause of death and other causes mentioned on [the] death certificate using an extended underlying-cause model." (SUMMARY IN FRE AND ITA)

Asia↗