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  • 1
    Electronic Resource
    Electronic Resource
    Non-dietary factors as risk factors for breast cancer, and as effect modifiers of the association of fat intake and risk of breast cancer (1997)
    Springer
    Cancer causes & control 8 (1997), S. 49-56 
    Details
    ISSN: 1573-7225
    Keywords: Breast cancer ; diet ; reproductive factors ; women
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To assess more precisely the relative risks associated with established risk factors for breast cancer, and whether the association between dietary fat and breast cancer risk varies according to levels of these risk factors, we pooled primary data from six prospective studies in North America and Western Europe in which individual estimates of dietary fat intake had been obtained by validated food-frequency questionnaires. Based on information from 322,647 women among whom 4,827 cases occurred during follow-up: the multivariate-adjusted risk of late menarche (age15 years or more compared with under 12) was 0.72 (95 percent confidence interval [CI]=0.62-0.82); of being postmenopausal was 0.82 (CI=0.69-0.97); of high parity (three or more births compared with none) was 0.72 (CI=0.61-0.86); of late age at first birth (over 30 years of age compared with 20 or under) was 1.46 (CI=1.22-1.75); of benign breast disease was 1.53 (CI=1.41-1.65); of maternal history of breast cancer was 1.38 (CI=1.14-1.67); and history of a sister with breast cancer was 1.47 (CI=1.27-1.70). Greater duration of schooling (more than high-school graduation compared with less than high-school graduation) was associated significantly with higher risk in age-adjusted analyses, but was attenuated after controlling for other risk factors. Total fat intake (adjusted for energy consumption) was not associated significantly with breast cancer risk in any strata of these non-dietary risk factors. We observed a marginally significant interaction between total fat intake and risk of breast cancer according to history of benign breast disease, with fat intake being associated nonsignificantly positively with risk among women with a previous history of benign breast disease; no other significant interactions were observed. Risks for reproductive factors were similar to those observed in case-control studies; relative risks for family history of breast cancer were lower. We found no clear evidence in any subgroups of a major relation between total energy-adjusted fat intake and breast cancer.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1018431104786
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  • 2
    Electronic Resource
    Electronic Resource
    Reproductive factors and family history of breast cancer in relation to plasma estrogen and prolactin levels in postmenopausal women in the Nurses' Health Study (United States) (1995)
    Springer
    Cancer causes & control 6 (1995), S. 217-224 
    Details
    ISSN: 1573-7225
    Keywords: Breast cancer ; endogenous hormones ; family history ; postmenopausal women ; reproductive factors ; United States
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Parity, age at first birth, age at menarche, and a family history of breast cancer have each been associated consistently with breast cancer risk. Whether this increase in risk is mediated, at least in part, through changes in endogenous hormone levels is unclear. We conducted a cross-sectional study of the relationships between these factors and plasma hormone levels in 216 healthy postmenopausal women in the Nurses' Health Study (United States). The hormones evaluated were estradiol, percent and total free estradiol, percent and total bioavailable estradiol, estrone, estrone sulfate, and prolactin. After controlling for age, body mass index (weight/height2), and alcohol use, we observed inverse associations between estrone sulfate and parity (r=−0.15, P=0.03) and between percent bioavailable estradiol and age at first birth (r=−0.17, P=0.02). Although women with a family history of breast cancer tended to have higher estrogen levels compared with women without such history, the differences were not statistically significant. Age at menarche was not related significantly to any of the hormones. These data provide some additional evidence that the inverse relationship observed between parity and breast cancer risk may be mediated, at least in part, through decreased estrogen levels. Our data do not support a substantial influence of either family history of breast cancer or age at menarche on postmenopausal estrogen or prolactin levels.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00051793
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Clinical evaluation of the ‘head-up’ display of anesthesia data (1995)
    Springer
    Journal of clinical monitoring and computing 12 (1995), S. 21-24 
    Details
    ISSN: 1573-2614
    Keywords: monitoring ; physiologic ; human factors ; display ; head-up ; private eye
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract To solve the problem of monitoring the patient during administration of anesthesia, a commercially available headup display (HUD) was evaluated during one day of surgery at the Ohio State University Hospitals. This monitor is mounted on a headband worn by the anesthesiologist. It projects a monochrome image of monitor data directly into one eye. Eleven anesthesiologists tested the device. Most users were able to adjust to the monitor in about fifteen minutes. Nine of the testers expressed a desire to evaluate the monitor further. Their major complaints were that the connecting cable between the HUD and its computer was too short, the resolution of the monitor was inadequate, and the data on the screen were not organized in a familiar way. If these problems could be corrected, most users believed that this HUD could be a valuable tool to aid the anesthesiologist in the operating room.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01142442
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    The Diatek Arkive “Organizer” Patient Information Management System: Experience at a University Hospital (1998)
    Springer
    Journal of clinical monitoring and computing 14 (1998), S. 89-94 
    Details
    ISSN: 1573-2614
    Keywords: Anesthesia ; automatic ; recordkeeping ; medical records ; computers ; human factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract Objective. To install and successfully use early commercial automatic anesthesia recordkeepers, the Diatek Arkive “Organizer” units, in the operating rooms at a major university medical center. Methods. Because of the history of previous academic attempts at automatic anesthesia recordkeeping, the units were installed on a “surprise” basis, with hardly any discussion of the devices beforehand. Results. The devices themselves had a number of minor difficulties at the start, most of which were promptly corrected. Eventually the units were in use in all non-cardiac general operating rooms. At one point, usage reached over 90% of possible cases. Continued opposition to the device on the part of certain individuals, coupled with the obsolescence of the present devices in light of new technology, led to the eventual abandonment of the system and removal of the devices from service. Discussion. Total resistance to the new devices on the part of a few vocal faculty members was a major factor in the ultimate downfall of the system. The method of introduction, and especially the lack of involvement of faculty, residents, surgeons, operating room personnel, hospital computer personnel, and the hospital administration in the installation also played a role in the failure of the system. Lack of a workable training mechanism for new residents prevented that user group from rapidly gaining comfort with the systems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1007488821284
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Observations on Use of Wrong Agent in an Anesthesia Agent Vaporizer (1999)
    Springer
    Journal of clinical monitoring and computing 15 (1999), S. 57-61 
    Details
    ISSN: 1573-2614
    Keywords: Equipment ; monitoring ; anesthesia, inhalational ; anesthetics, volatile ; halothane ; enflurane ; isoflurane ; vaporizer ; key-filling systems ; mixture ; errors ; human factors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract The creation of agent mixtures from the addition of the wrong agent to a vaporizer might pose a risk to the patient. Patient injury would be more likely if the anesthesia gas monitor displayed erroneous concentration values. Conventional inhalation agent monitors do not necessarily distinguish anesthetic agents. Some modern monitors have that ability but its clinical significance has not been determined. We wanted to simulate such an erroneous mixture in a laboratory setup. Six comparisons were made. Isoflurane, Enflurane, and Halothane vaporizers were first filled with the correct agent. They were run at 5 liters/minute fresh oxygen flow at a vaporizer dial setting of 5% until it reached the “refill” line. Then, one of two incorrect agents was added to the “full” line. Thereafter, the vaporizer continued at the same flow and the same dial setting until it was exhausted. Vaporizer output was recorded or calculated by using three methods of measurement: mass spectrometry, conventional infrared analysis (at 3.3 micrometer wave length), and piezoelectric crystal analysis. Additional calculations were used to estimate measurements that could not be made because of lack of available equipment. In a Halothane vaporizer: Enflurane added – not a significant problem; Isoflurane added – not a significant problem. In an Isoflurane vaporizer: Halothane added – not a significant problem; Enflurane added – not a significant problem. In an Enflurane vaporizer: Isoflurane added – not a significant problem; Halothane added – The sum of the delivered Halothane MAC and the delivered Enflurane MAC was twice the expected Enflurane MAC output from vaporizer, with conventional agent monitor reading which showed decreasing agent concentration. Patient injury could be more likely in this last case. In this last case and in all cases, piezoelectric crystal monitoring correctly displayed the sum of the two agent concentrations in volumes percent. Automatic agent identification can identify erroneous agents.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1009979531850
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    Paper (German National Licenses)
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