ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Chronic disease conditions that are associated with elevated proliferation are well established as risk factors for cancer development. These may be due to viruses (for example, in the case of hepatitis and liver cancer), bacterial infections, parasite infestation or physical trauma. In addition to these exogenous agents there are also metabolic abnormalities that can contribute, caused by genetic or epigenetic influence. In the latter case, an increase in serum levels of the hormones oestrogen, testosterone and insulin may be of special importance. The present review concentrates attention on factors that induce elevated cell turnover and for which there is epidemiological and/or experimental evidence of a link with neoplasia, with particular stress on the individual organ or tissue level.

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

In South African blacks colorectal cancers are uncommon and adenomatous polyps are rare, despite major changes in diet and lifestyle in the large urbanized community of Soweto (population over 3 million). Factors favouring adenomas formation are changes in bowel function. Thus, stool weights, defaecation frequencies, oro-caecal transit times and whole-gut transit times in Sowetans approximate those of western populations. Moreover a measure of westernization of diet has occurred, the salient feature being a greatly reduced fibre intake (14 g daily). Factors thought to inhibit adenoma formation are physiological malabsorption of maize, lactose and fructose. Sucrose activity is significantly lowered compared with whites. With regard to diet, fat consumption is well below that of western societies. There are differences in colon cell proliferation, faecal short chain fatty acids, faecal pH and colonic microflora compared with white groups. Equivocal factors that may be involved in adenoma formation are time trends and genetic background. In the context of the above it is apparent that in South African blacks inhibiting factors outweigh promotive factors in adenoma formation.

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

While multiple studies have investigated the association between serum cholesterol level and breast cancer, the results have generally been conflicting. No prior study has investigated its association with ductal carcinomain situ(DCIS) of the breast. In this hospital-based case-control study, 152 DCIS cases were compared to 242 controls (patients with benign surgical conditions). Unconditional logistic regression was used to compare the serum cholesterol levels, adjusting for relevant covariates. No statistically significant difference was observed for different quartiles of the serum cholesterol level as compared to the lowest quartile. Incidentally observed was an elevated risk for DCIS in postmenopausal versus premenopausal women, and in peri-menopausal versus premenopausal women. There is no apparent association between the serum cholesterol level and breast DCIS.

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The aim of this study was to analyse the reliability and the inter-observer agreement of dermoscopy in the diagnosis of melanocytic skin lesions. Nine dermatologists, with a different training experience and who routinely used dermoscopy in different hospitals in Italy, evaluated clinical and dermoscopy photographs of 15 melanocytic lesions (four invasive melanomas, four histologically common naevi, and seven naevi with histological atypia). A further series of dermoscopic photographs of 40 melanocytic lesions was evaluated to quantify inter-observer concordance in recognizing dermoscopic criteria. Compared to the true (histological) diagnosis, clinical diagnosis (categories: melanoma, common naevus, atypical naevus) was correct in 40% of cases (range, 27-53%). The percentage raised to 55% (40-73%) by the use of dermoscopy, with an average improvement of 15.6%. Concerning melanoma, clinical diagnosis resulted in a sensitivity of 41.9%, specificity of 77.8%, positive predictive value (PPV) of 36.1%, negative predictive value (NPV) of 81.8%. By using dermoscopy, an improvement of diagnostic performance was found (sensitivity 75%, specificity 88.8%, VPP 71.0%, VPN 90.7%). The inter-observer agreement in melanoma diagnosis, by using dermoscopy, was similar to that obtained by clinical examination (k statistics=0.54 and 0.52, respectively). Concerning dermoscopic criteria, the best agreement among observers was found for pseudopods, a dermoscopic parameter related to the radial growth phase of melanoma. We conclude that dermoscopy is an useful tool for a non-invasive diagnosis of melanocytic skin lesions, improving the diagnostic performance compared to clinical examination.

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

In the first half of 1992, the Board of Directors at the Karolinska Hospital decided that, as of 1 September 1992, smoking indoors would be prohibited for staff in the hospital. A year later, a new Tobacco Act was introduced in Sweden involving a general ban on smoking in all health care premises, including rooms which patients would have cause to visit or frequent regularly. Four years after the implementation of the policy decision, an evaluation was made based on the principles of data and method triangulation. In all, four substudies were carried out: (1) an observational study about outdoor smoking; (2) interviews with gardeners, cleaners and hospital hostesses/hosts; (3) inventory of sales points for tobacco products, the extent of tobacco advertising and an interview with the staff at a shop and a cafe; and (4) an observational study about the appearance of signs on buildings about the smoking policy. The results of the study shows that smoking was found mainly among the staff of the hospital, particularly around the entrances. No visible tobacco advertising could be seen at the hospital sales point, and a drop in tobacco sales was noted. The experiences of a smoke-free Karolinska Hospital are that a policy decision requires continuous follow-up and evaluation. Furthermore, the actions taken must be subject to quality control, and, simultaneously, smoke-quitting activities must be organized for staff who still smoke.

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

A great deal of information is already available regarding modifiable factors affecting cancer development in a negative or positive fashion. Thus, avoidance of harmful agents like tobacco, vaccination against virus infections, prompt treatment of inflammatory conditions and increased exposure to beneficial influences hold great promise for the achievement of effective prevention. However, this requires a co-ordinated strategy and an integration of efforts in epidemiological and biological research, medical practice and education, and is essential for optimal use of the resources available. In addition, more stress needs to be placed on community approaches. Concentration of particular attention on the 'ecological' interactions among a triad of the major areas of action: (1) information generation; (2) intervention efforts; and (3) government policy, appears warranted.

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0959-8278    

出版商:OVID    

年代:1998

数据来源: OVID