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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report a rare case of metastatic carcinoma of the large bowel, secondary to a primary bronchogenic adenocarcinoma. Abdominal pain developed in a 44-year old man 5 months after lobectomy for lung adenocarcinoma. The diagnosis of a large caecal extraluminal mass was established by means of sonography, scanner and laparoscopy. Palliative resection (brain metastases) was performed. Postoperative histological examination revealed the resected tumor to be identical to the lung adenocarcinoma. The patient eventually died 4 months after resection (complication of intracranial hypertension). Diagnosis and therapeutic features of metastatic extra-thoracic lung carcinoma are discussed.
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PMID:[An unusual secondary localization of bronchial adenocarcinoma]. 831 14

Participation in physical activity on a regular basis provides important health benefits, including reduced risk for heart disease, colon cancer, diabetes, and high blood pressure. Regular physical activity also helps control weight; contributes to development and maintenance of healthy bones, muscles, and joints; and reduces symptoms of anxiety and depression. Recent recommendations have emphasized moderate intensity activities nearly every day for those who are unable to maintain the previously recommended program of strenuous activity three times a week. To determine the proportion of adults who are participating in regular physical activity, regardless of the level of intensity, CDC analyzed data from the 1994 Behavioral Risk Factor Surveillance System (BRFSS). This report summarizes the results of that analysis, which indicates that, in every state surveyed, most adults are not participating in regular physical activity.
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PMID:State-specific prevalence of participation in physical activity--Behavioral Risk Factor Surveillance System, 1994. 876 58

Ca2+ channel blockers may cause cancer by inhibiting apoptosis or reducing intracellular Ca2+ in certain tissues. Recent findings suggest that drug users are at increased risk for cancer in general and for colon cancer in particular. We conducted a study in one Danish county of 17911 patients who received at least one prescription of Ca2+ channel blockers between 1 January 1991 and 31 December 1993. The patients were identified from records in the National Health Insurance Program, which refunds part of the price of such drugs. Cancer occurrence and rate were determined by use of the files of the Danish Cancer Registry and compared with county-specific incidence rates for various categories of cancer. During the follow-up period of up to 3 years, 412 cancers were observed among users of Ca2+ channel blockers, compared with 414 expected, to yield an age- and sex-standardized incidence ratio (SIR) of 1.00 (95% confidence interval, 0.90 to 1.10). There was no indication of an excess risk in the subgroup of likely long-term users or users of specific drugs. The SIR of colon cancer, a site of a priori interest, was 0.8 (95% confidence interval, 0.5 to 1.1) on the basis of 34 cases. Although the results are reassuring, the lack of association could reflect the relatively short follow-up after registration in the prescription database. Continued monitoring of cancer risk is planned.
Hypertension 1997 May
PMID:Cancer risk in users of calcium channel blockers. 940 98

Physical inactivity increases the risk for heart disease, diabetes, colon cancer, high blood pressure, obesity, osteoporosis, muscle and joint disorders, and symptoms of anxiety and depression. However, approximately one third of adults in the United States report no leisure-time physical activity, and rates of inactivity have been higher in January than in June. Among adults, the prevalence of leisure-time physical inactivity is highest among those who are older, Hispanic, and residing in southern states. A national health objective for the year 2000 is to reduce to < or = 15% the proportion of persons reporting no leisure-time physical activity (objecive 1.5). To assist in monitoring efforts to achieve this objective, CDC analyzed data from the 1994 Behavioral Risk Factor Surveillance system (BRFSS) and estimated for each month the proportion of adults from selected demographic groups who reported no leisure-time physical activity. The findings indicate seasonal patterns in the prevalence of reported leisure-time physical inactivity; however, monthly rates of inactivity were higher and more stable among older persons, Hispanics, and residents of southern states.
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PMID:Monthly estimates of leisure-time physical inactivity--United States, 1994. 915 73

Both the current and past surgeon generals of the United States and the Public Health objectives for Healthy People 2000 have identified family violence as an epidemic and have called for an organized approach to screen, treat, and prevent further violence. Domestic violence is not, and never has been, a "disease" of the poor. Thousands of women from high socioeconomic levels are beginning to shatter our visual image of an abused woman and are forcing us to look at current primary care screening practices and interventions. Domestic violence is as common, and in some cases more prevalent, as diseases routinely screened for such as breast cancer, hypothyroidism, hypertension, and colon cancer. One of the barriers to universal screening of domestic violence is our reliance on the profile of the typical battered woman. One often neglected population is women from higher socioeconomic groups. This article provides the rationale for universal screening of all women for domestic violence.
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PMID:The importance of screening for domestic violence in all women. 917 38

Calcium is necessary for the prevention and treatment of diseases such as osteoporosis, hypertension, and, possibly, colon cancer. Supplementation is useful when dietary calcium intake is low, as is the current situation in North America. There are many factors to consider before recommending any one form of supplement. A consideration for calcium carbonate tablets is whether the tablet disintegrates and whether or not a lack of food or acid in the stomach will hinder utilization. Other forms of calcium, particularly the chelated calcium salts, are better absorbed in fasting achlorhydric subjects but have less calcium per gram of supplement. Interaction of calcium with other mineral nutrients and the presence of contaminating metals has focused attention on safety. Based on present evidence, chelated calcium and refined calcium carbonate tablets (including those labeled as antacids) may be safely and effectively ingested by most people at doses generally recommended for treatment or prevention of osteoporosis. One should not exceed 2,000 mg of calcium, except at the advice of their health care provider, as inadvertent mineral deficiencies may arise. Persons at risk for developing milk-alkali syndrome, such as thiazide users and persons with renal failure, should be identified and monitored for alkalosis and hypercalcemia when using calcium supplements.
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PMID:Calcium supplementation. 927 39

The concept of predictive medicine based on the detection of genetic markers for disease susceptibility stemmed from the finding that many diseases are associated with specific HLA alleles. This model suggested that similar associations probably existed with other genes located all along the human genome. The Human Specimen Study Center (HSSC) was created to assist in investigating this possibility and has contributed significantly to the knowledge contained in current genetic and physical human genome maps. Predictive medicine is intended not for patients but for healthy individuals, its goal being to determine whether their susceptibility to a specific disease is increased or not. Fetuses with evidence of disease are excluded from the province of predictive medicine, which can, however, determine whether a healthy fetus is at high risk for developing a disease in adolescence or adulthood. Predictive medicine is based on probabilities: it evaluates diseases susceptibility but cannot predict with 100% certainty that a specific disease will occur. Whereas many preventive interventions are directed at groups (e.g., immunization programs), predictive medicine is conducted on an individualized basis. For instance, glaucoma is a monogenic disease whose early detection can allow to prevent permanent loss of vision. The fruits of predictive medicine are expected to be greatest, however, in the polygenic multifactorial diseases that are prevalent in industrialized countries, such as diabetes mellitus, hypertension, myocardial infarction, hyperlipidemia, and arteriosclerosis. An ability to detect subjects who are susceptible to breast cancer would be extraordinarily useful, and may be a goal within reach since two breast cancer susceptibility genes have already been identified. Genes associated with increased susceptibility to colon cancer have also been reported. Predictive medicine raises a number of sensitive ethical issues. Individuals should be free to accept or decline disease susceptibility testing after having been fully informed. Confidentiality is vital. The results of susceptibility tests should not be made available to employers or insurance agencies. Susceptibility testing should be offered only if the disease requires a specific treatment or lifestyle modification. Unnecessary anxiety may be one of the main adverse effects of susceptibility testing. A large number of disease susceptibility or resistance genes will probably be identified in the near future, and this will inevitably have an impact on the way physicians approach their patients. Physicians in the XXIst century will spend an increasingly large proportion of their time counselling their patients on how to stay healthy. This trend can be expected to translate into a marked increase in life expectancy. Rather than seeking to add years to life, physicians will strive to add life to years.
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PMID:[Predictive medicine and its ethics]. 929 63

This study was undertaken to update and revise the estimate of the economic impact of obesity in the United States. A prevalence-based approach to the cost of illness was used to estimate the economic costs in 1995 dollars attributable to obesity for type 2 diabetes mellitus, coronary heart disease (CHD), hypertension, gallbladder disease, breast, endometrial and colon cancer, and osteoarthritis. Additionally and independently, excess physician visits, work-lost days, restricted activity, and bed-days attributable to obesity were analyzed cross-sectionally using the 1988 and 1994 National Health Interview Survey (NHIS). Direct (personal health care, hospital care, physician services, allied health services, and medications) and indirect costs (lost output as a result of a reduction or cessation of productivity due to morbidity or mortality) are from published reports and inflated to 1995 dollars using the medical component of the consumer price index (CPI) for direct cost and the all-items CPI for indirect cost. Population-attributable risk percents (PAR%) are estimated from large prospective studies. Excess work-lost days, restricted activity, bed-days, and physician visits are estimated from 88,262 U.S. citizens who participated in the 1988 NHIS and 80,261 who participated in the 1994 NHIS. Sample weights have been incorporated into the NHIS analyses, making these data generalizable to the U.S. population. The total cost attributable to obesity amounted to $99.2 billion dollars in 1995. Approximately $51.64 billion of those dollars were direct medical costs. Using the 1994 NHIS data, cost of lost productivity attributed to obesity (BMI> or =30) was $3.9 billion and reflected 39.2 million days of lost work. In addition, 239 million restricted-activity days, 89.5 million bed-days, and 62.6 million physician visits were attributable to obesity in 1994. Compared with 1988 NHIS data, in 1994 the number of restricted-activity days (36%), bed-days (28%), and work-lost days (50%) increased substantially. The number of physician visits attributed to obesity increased 88% from 1988 to 1994. The economic and personal health costs of overweight and obesity are enormous and compromise the health of the United States. The direct costs associated with obesity represent 5.7% of our National Health Expenditure in the United States.
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PMID:Current estimates of the economic cost of obesity in the United States. 954 25

We report a case of aneurysmal rupture of the pancreaticoduodenal artery successfully treated by transcatheter arterial embolization. A 61-year-old man with a history of hypertension underwent surgery at our hospital in November 1995 for local peritonitis caused by perforation of the sigmoid colon secondary to cancer. On the 9th postoperative day, he developed shock, with complaints of epigastric and back pain. Abdominal computed tomography showed an enhanced mass, thought to be a peripancreatic aneurysm. Emergency angiography demonstrated an aneurysm arising from the arcade of the anterior pancreaticoduodenal artery. After diagnostic angiography, transcatheter arterial embolization was performed. With steel coils, the anterior superior pancreaticoduodenal artery and anterior inferior pancreaticoduodenal artery were embolized near the origin of the aneurysm. Angiography 7 weeks later revealed no recanalization of the aneurysm and the absence of anomalous collateral vessels. The patient has been well for 19 months without re-bleeding or recurrence of sigmoid colon cancer. Transcatheter arterial embolization is an effective therapeutic approach for aneurysm of the pancreaticoduodenal artery and is the preferred initial treatment.
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PMID:Aneurysmal rupture of the pancreaticoduodenal artery successfully treated by transcatheter arterial embolization. 968 62

Since fiscal year 1991, the U.S. Human Genome Project has spent $170.6 million in federal funds to help isolate genes associated with Huntington's disease, amyotrophic lateral sclerosis, neurofibromatosis types 1 and 2, myotonic dystrophy, and fragile X syndrome and to localize genes that predispose people to breast cancer, colon cancer, hypertension, diabetes, and Alzheimer's disease. Now comes the hard part. Biology's 21st century megaproject starts to look relatively manageable compared to another challenge facing the enterprise: sorting out ethical, legal, and social issues associated with using this information. "The Human Genome Project," wrote Senior Editor Barbara Jasny in the October 1 Science editorial, stretches "the limits of the technology and the limits of our ability to ethically and rationally apply genetic information to our lives."
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PMID:Ethical, legal, and social issues of the Human Genome Project: what to do with what we know. 971 68


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