Family history of breast and ovarian cancer and the risk of breast carcinoma in situ.

Unlabelled: A family history of breast cancer is an important risk factor for breast carcinoma in situ (BCIS), however, there are no detailed analyses of its variation in effect by number, type, laterality or age at onset of affected relatives nor by association with ovarian cancer. In addition, the role of the breast cancer susceptibility genes, BRCA1 and BRCA2, in the development of BCIS is unclear.

Objective: To better define the role of: (1) a family history of breast and ovarian cancer and (2) the cancer susceptibility genes, BRCA1 and BRCA2, in the development of BCIS.

Practice-related effects demonstrate complementary roles of anterior cingulate and prefrontal cortices in attentional control.

The purpose of this study was to test the hypothesis that the dorsolateral prefrontal cortex (DLFPC), not the anterior cingulate cortex (ACC), plays the predominant role in implementing top-down attentional control. To do so, we used fMRI to examine practice-related changes in neural activity during a variant of the Stroop task. The results indicated that the DLPFC's activity decreased gradually as the need for control was reduced (as indexed by behavioral measures), while the ACC's activity dropped off rapidly.

Active signaling by HER-2/neu in a subpopulation of HER-2/neu-overexpressing ductal carcinoma in situ: clinicopathological correlates.

HER-2/neu overexpression occurs in a proportion of invasive breast carcinomasand is an adverse prognostic indicator, although its apparent strength as a prognostic indicator varies in different studies. Paradoxically, HER-2/neu is overexpressed with particularly high frequency in ductal carcinoma in situ (DCIS). We have hypothesized and presented supporting data that HER-2/neu is actively signaling in a subset of the tumors in which it is overexpressed.

Breast carcinoma in situ: risk factors and screening patterns.

Background: Risk factors associated with invasive breast cancer are well documented, but those associated with breast carcinoma in situ are not well defined.

Methods: We conducted a population-based, case-control study among female residents of Connecticut to identify risk factors for breast carcinoma in situ. Case patients, diagnosed with ductal carcinoma in situ (DCIS) (n = 875) or lobular carcinoma in situ (LCIS) (n = 123), were matched by 5-year age groups with control subjects (n = 999).

Pathobiologic findings in DCIS of the breast: morphologic features, angiogenesis, HER-2/neu and hormone receptors.

With the increasing incidence of ductal carcinoma in situ (DCIS) of the breast and its relationship to invasive breast carcinoma, it is important to understand the biology of this entity. We report on a hospital-based survey of 219 case subjects with DCIS of the breast without associated invasive carcinoma diagnosed between 1982 and 1994. The cases of DCIS were analyzed for architectural type, size, nuclear grade, necrosis, calcification, periductal fibrosis, neovascularization, estrogen receptor (ER), progesterone receptor (PR), and HER-2/neu expression.

Risk models in genetic epidemiology.

Advances in the identification and treatment of genetically transmitted diseases have lead to an increased need for reliable estimates of genetic susceptibility risk. These estimates are used in clinic settings to identify individuals at increased risk of being a carrier of a disease susceptibility allele as well as to define the probability of developing a particular disease given one is a carrier. Accurate assessment of these probabilities is extremely important given the implications for medical decision making including the identification of patients who might benefit from genetic counselling or from entry into clinical trials.

The first total synthesis of +-ratjadone.

The first total synthesis of ratjadone was achieved using a highly convergent approach joining three subunits together with a Wittig olefination and a selective Heck reaction as the pivotal steps. Besides establishing a robust and reliable route for the synthesis of this orphan ligand, the configuration of unknown stereocenters could also be determined. This synthesis not only provides an additional access to a biologically important compound but also enables the synthesis of structural analogues for biological target identification.

Toward more rational prediction of outcome in patients with high-grade subarachnoid hemorrhage.

Objective: Accurate outcome prediction after high-grade subarachnoid hemorrhage remains imprecise. Several clinical grading scales are in common use, but the timing of grading and changes in grade after admission have not been carefully evaluated. We hypothesized that these latter factors could have a significant impact on outcome prediction.

Effect of BRCA1 and BRCA2 on the association between breast cancer risk and family history.

Background: The discovery of BRCA1 and BRCA2 has led to a reassessment of the association between family history of breast/ovarian cancer and breast cancer risk after controlling for carrier status for mutations in the BRCA1 and BRCA2 genes. We examined whether family history of breast cancer remains a predictive risk factor for this disease after carrier status for BRCA1 and/or BRCA2 mutations is taken into consideration.

Methods: The data are from 4730 case subjects with breast cancer and 4688 control subjects enrolled in the Cancer and Steroid Hormone Study.

Does multiple risk factor reduction explain the reduction in fall rate in the Yale FICSIT Trial? Frailty and Injuries Cooperative Studies of Intervention Techniques.

In a recent study of fall prevention in 301 community-living older persons (the Yale FICSIT Trial, 1990-1993), participants in the multifactorial targeted intervention (TI) group experienced significantly fewer falls than participants in the social visit (SV) control group. In the present paper, the authors explore the relation between changes in the studied risk factors and the occurrence of falling. In comparison with SV participants, TI participants showed significantly greater improvements in postural blood pressure change (p = 0.

The genetic attributable risk of breast and ovarian cancer.

Background: The age-specific proportion of breast and ovarian cancer in the general population that is likely to be due to a breast/ovarian cancer susceptibility gene(s) is estimated. In addition, the age-specific penetrance of ovarian cancer for women predicted to be carriers of a susceptibility gene is calculated using population-based data.

Methods: Data are from the Cancer and Steroid Hormone Study, a population-based, case-control study conducted by the Centers for Disease Control, which includes 4730 breast cancer cases aged 20 to 54 years.

Familial ovarian cancer. Update and clinical applications.

Background: Genetics plays a role in all cancers. Evidence exists for the presence of inherited genes associated with the development of ovarian cancer in three familial ovarian cancer syndromes: a site-specific ovarian cancer syndrome, a breast/ovarian cancer syndrome, and an ovarian cancer syndrome associated with hereditary nonpolyposis colorectal cancer.

Methods And Results: The authors present an updated summary of recent advances within the field of ovarian cancer genetics and examine the extent to which this genetic information, at both an epidemiologic and molecular level, may be used to identify a subset of women who are likely to be at increased risk of developing ovarian cancer.

Risk factors for serious injury during falls by older persons in the community.

Background: Serious fall injury represents a little studied, yet common and potentially preventable, cause of morbidity and mortality among older persons. We determined the frequency of, and risk factors for, experiencing serious fall injury events among older persons in the community.

Subjects: A representative sample of 1103 community-living persons aged 72 years and older underwent comprehensive baseline and 1-year evaluations.

The contribution of predisposing and situational risk factors to serious fall injuries.

Objectives: The objectives were to identify situational risk factors associated with suffering a serious fall injury and to determine whether, and to what extent, predisposing and situational risk factors contributed independently to risk of suffering a serious fall injury.

Design: Nested cohort study.

Setting: General community.

The genetic epidemiology of cancer.

Although every cancer is unique, similarities do exist with regard to the genetic epidemiology of many of the more common cancers such as breast, ovary, colon and prostate. For each of these cancers, a small subset of cases exist that are attributable to rare inherited mutant genes. Since cancer is a multistep process, individuals with inherited mutations are at increased risk and tend to develop cancer at an earlier age than do those who acquire the mutations after birth.

A multifactorial intervention to reduce the risk of falling among elderly people living in the community.

Background: Since falling is associated with serious morbidity among elderly people, we investigated whether the risk of falling could be reduced by modifying known risk factors.

Methods: We studied 301 men and women living in the community who were at least 70 years of age and who had at least one of the following risk factors for falling: postural hypotension; use of sedatives; use of at least four prescription medications; and impairment in arm or leg strength or range of motion, balance, ability to move safely from bed to chair or to the bathtub or toilet (transfer skills), or gait. These subjects were given either a combination of adjustment in their medications, behavioral instructions, and exercise programs aimed at modifying their risk factors (intervention group, 153 subjects) or usual health care plus social visits (control group, 148 subjects).

[Sore throat patients as the topic of a general practice quality circle. Determination and development of a practice guideline. Quality Assurance Study group for General Medicine].

Unlabelled: The present paper describes the institutionalization of a general practitioners' quality circle and the development of management guidelines for the treatment of patients with sore throat. Doctors participating: An invitation to attend an "information meeting" on the subject quality control and a quality circle sent to 200 general practitioners and internists, evoked a response by 18 physicians, ten of whom participated in the first meeting of the quality circle. Practical procedure: Stocktaking of the procedure in the doctor's office on the basis of a documentation questionnaire, the discussion of a video of the counselling of a patient with a sore throat, interviews with patients and the personal experience of the participating physicians was compared with a current analysis of the literature.

Autosomal dominant inheritance of early-onset breast cancer. Implications for risk prediction.

Background: Improvements in screening techniques have made significant contributions to the early detection of breast cancer. Physicians thus face the task of providing appropriate screening schedules for their patients. One group for whom this is particularly important are those women with a family history of breast cancer.

Genetic epidemiology of breast cancer in younger women.

Genetics plays a role in all of breast cancer. At present, however, inherited genes associated with the development of breast cancer have more frequently been identified in women with an early age at onset. This review examines the extent to which genetic information, at both an epidemiologic and molecular level, may be used to identify a subset of women who are likely to be at increased risk of developing breast cancer at an early age.

The calculation of breast cancer risk for women with a first degree family history of ovarian cancer.

Recent linkage analyses demonstrate the strength of the genetic association between breast and ovarian cancer in some families. These findings highlight the importance of considering a woman's family history of ovarian cancer in the calculation of her risk of breast cancer. In this study, data on breast and ovarian cancer from the Cancer and Steroid Hormone Study, a large, population-based, case-control study conducted by the Centers for Disease Control, are used to calculate age-specific and cumulative risks of developing breast cancer for a woman with a first degree family history of ovarian cancer.

Allelic loss in ovarian cancer.

Loss of heterozygosity (LOH) was examined at 86 loci distributed on every chromosomal arm in 50 human ovarian tumors. Frequent allele losses were observed on chromosomes 13q (42%), 17p (42%), 17q (45%), and Xp (41%). Deletion mapping on chromosome 17 revealed a candidate gene on the long arm distal to D17S41/S74 for ovarian cancer which is distant from the locus for early onset breast cancer.

Predictors and prognosis of inability to get up after falls among elderly persons.

Objective: To identify the predictors and prognosis associated with inability to get up after falling.

Design: Cohort study with a mean 21-month follow-up.

Setting: General community.