Author
Robert S. Sandler
Other affiliations: Mayo Clinic, University of Texas Southwestern Medical Center, National Institutes of Health ...read more
Bio: Robert S. Sandler is an academic researcher from University of North Carolina at Chapel Hill. The author has contributed to research in topics: Population & Colorectal cancer. The author has an hindex of 88, co-authored 521 publications receiving 39992 citations. Previous affiliations of Robert S. Sandler include Mayo Clinic & University of Texas Southwestern Medical Center.
Papers published on a yearly basis
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TL;DR: Among patients with a history of colorectal adenomas, the use of rofecoxib was associated with an increased cardiovascular risk, and cardiovascular mortality was similar in the two groups.
Abstract: background Selective inhibition of cyclooxygenase-2 (COX-2) may be associated with an increased risk of thrombotic events, but only limited long-term data have been available for analysis. We report on the cardiovascular outcomes associated with the use of the selective COX-2 inhibitor rofecoxib in a long-term, multicenter, randomized, placebo-controlled, double-blind trial designed to determine the effect of three years of treatment with rofecoxib on the risk of recurrent neoplastic polyps of the large bowel in patients with a history of colorectal adenomas. methods A total of 2586 patients with a history of colorectal adenomas underwent randomization: 1287 were assigned to receive 25 mg of rofecoxib daily, and 1299 to receive placebo. All investigator-reported serious adverse events that represented potential thrombotic cardiovascular events were adjudicated in a blinded fashion by an external committee. results A total of 46 patients in the rofecoxib group had a confirmed thrombotic event during 3059 patient-years of follow-up (1.50 events per 100 patient-years), as compared with 26 patients in the placebo group during 3327 patient-years of follow-up (0.78 event per 100 patient-years); the corresponding relative risk was 1.92 (95 percent confidence interval, 1.19 to 3.11; P=0.008). The increased relative risk became apparent after 18 months of treatment; during the first 18 months, the event rates were similar in the two groups. The results primarily reflect a greater number of myocardial infarctions and ischemic cerebrovascular events in the rofecoxib group. There was earlier separation (at approximately five months) between groups in the incidence of nonadjudicated investigator-reported congestive heart failure, pulmonary edema, or cardiac failure (hazard ratio for the comparison of the rofecoxib group with the placebo group, 4.61; 95 percent confidence interval, 1.50 to 18.83). Overall and cardiovascular mortality was similar in the two groups. conclusions Among patients with a history of colorectal adenomas, the use of rofecoxib was associated with an increased cardiovascular risk.
2,471 citations
TL;DR: The burden of GI disease in the United States is estimated and the most common GI symptom is abdominal pain, while the total cost for outpatient GI endoscopy examinations was $32.4 billion.
1,741 citations
TL;DR: The most prevalent diseases were non-food-borne gastroenteritis, food-borne illness, gastroesophageal reflux disease, and irritable bowel syndrome, followed by gallbladder disease, which had the highest annual direct costs in the United States.
1,410 citations
Dartmouth College1, University of North Carolina at Chapel Hill2, University of Southern California3, Veterans Health Administration4, University of Colorado Denver5, Henry Ford Health System6, University of Toronto7, University of Iowa8, Cleveland Clinic9, University of Minnesota10, Emory University11
TL;DR: Low-dose aspirin has a moderate chemopreventive effect on adenomas in the large bowel, using generalized linear models to compute risk ratios and 95 percent confidence intervals.
Abstract: Background Laboratory and epidemiologic data suggest that aspirin has an antineoplastic effect in the large bowel. Methods We performed a randomized, double-blind trial of aspirin as a chemopreventive agent against colorectal adenomas. We randomly assigned 1121 patients with a recent history of histologically documented adenomas to receive placebo (372 patients), 81 mg of aspirin (377 patients), or 325 mg of aspirin (372 patients) daily. According to the protocol, follow-up colonoscopy was to be performed approximately three years after the qualifying endoscopy. We compared the groups with respect to the risk of one or more neoplasms (adenomas or colorectal cancer) at least one year after randomization using generalized linear models to compute risk ratios and 95 percent confidence intervals. Results Reported adherence to study medications and avoidance of nonsteroidal antiinflammatory drugs were excellent. Follow-up colonoscopy was performed at least one year after randomization in 1084 patients (97 perc...
1,330 citations
TL;DR: In this paper, the authors conducted a randomized, double-blind trial to determine the effect of aspirin on the incidence of colorectal adenomas, which was terminated early by an independent data and safety monitoring board when statistically significant results were reported during a planned interim analysis.
Abstract: Background Experimental studies in animals and observational studies in humans suggest that regular aspirin use may decrease the risk of colorectal adenomas, the precursors to most colorectal cancers. Methods We conducted a randomized, double-blind trial to determine the effect of aspirin on the incidence of colorectal adenomas. We randomly assigned 635 patients with previous colorectal cancer to receive either 325 mg of aspirin per day or placebo. We determined the proportion of patients with adenomas, the number of recurrent adenomas, and the time to the development of adenoma between randomization and subsequent colonoscopic examinations. Relative risks were adjusted for age, sex, cancer stage, the number of colonoscopic examinations, and the time to a first colonoscopy. The study was terminated early by an independent data and safety monitoring board when statistically significant results were reported during a planned interim analysis. Results A total of 517 randomized patients had at least one colon...
1,111 citations
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28 Jul 2005
TL;DR: PfPMP1）与感染红细胞、树突状组胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作�ly.
Abstract: 抗原变异可使得多种致病微生物易于逃避宿主免疫应答。表达在感染红细胞表面的恶性疟原虫红细胞表面蛋白1（PfPMP1）与感染红细胞、内皮细胞、树突状细胞以及胎盘的单个或多个受体作用，在黏附及免疫逃避中起关键的作用。每个单倍体基因组var基因家族编码约60种成员，通过启动转录不同的var基因变异体为抗原变异提供了分子基础。
18,940 citations
TL;DR: It is now becoming clear that the tumour microenvironment, which is largely orchestrated by inflammatory cells, is an indispensable participant in the neoplastic process, fostering proliferation, survival and migration.
Abstract: Recent data have expanded the concept that inflammation is a critical component of tumour progression. Many cancers arise from sites of infection, chronic irritation and inflammation. It is now becoming clear that the tumour microenvironment, which is largely orchestrated by inflammatory cells, is an indispensable participant in the neoplastic process, fostering proliferation, survival and migration. In addition, tumour cells have co-opted some of the signalling molecules of the innate immune system, such as selectins, chemokines and their receptors for invasion, migration and metastasis. These insights are fostering new anti-inflammatory therapeutic approaches to cancer development.
12,395 citations
TL;DR: A quantitative integration and review of research on the Theory of Planned Behaviour and the subjective norm, which found that intentions and self-predictions were better predictors of behaviour than attitude, subjective norm and PBC.
Abstract: The Theory of Planned Behaviour (TPB) has received considerable attention in the literature. The present study is a quantitative integration and review of that research. From a database of 185 independent studies published up to the end of 1997, the TPB accounted for 27% and 39% of the variance in behaviour and intention, respectively. The perceived behavioural control (PBC) construct accounted for significant amounts of variance in intention and behaviour, independent of theory of reasoned action variables. When behaviour measures were self-reports, the TPB accounted for 11% more of the variance in behaviour than when behaviour measures were objective or observed (R2s = .31 and .21, respectively). Attitude, subjective norm and PBC account for significantly more of the variance in individuals' desires than intentions or self-predictions, but intentions and self-predictions were better predictors of behaviour. The subjective norm construct is generally found to be a weak predictor of intentions. This is partly attributable to a combination of poor measurement and the need for expansion of the normative component. The discussion focuses on ways in which current TPB research can be taken forward in the light of the present review.
8,889 citations
TL;DR: The evidence is recounted that atherosclerosis, the main cause of CAD, is an inflammatory disease in which immune mechanisms interact with metabolic risk factors to initiate, propagate, and activate lesions in the arterial tree.
Abstract: ecent research has shown that inflammation plays a key role in coronary artery disease (CAD) and other manifestations of atherosclerosis. Immune cells dominate early atherosclerotic lesions, their effector molecules accelerate progression of the lesions, and activation of inflammation can elicit acute coronary syndromes. This review highlights the role of inflammation in the pathogenesis of atherosclerotic CAD. It will recount the evidence that atherosclerosis, the main cause of CAD, is an inflammatory disease in which immune mechanisms interact with metabolic risk factors to initiate, propagate, and activate lesions in the arterial tree. A decade ago, the treatment of hypercholesterolemia and hypertension was expected to eliminate CAD by the end of the 20th century. Lately, however, that optimistic prediction has needed revision. Cardiovascular diseases are expected to be the main cause of death globally within the next 15 years owing to a rapidly increasing prevalence in developing countries and eastern Europe and the rising incidence of obesity and diabetes in the Western world. 1 Cardiovascular diseases cause 38 percent of all deaths in North America and are the most common cause of death in European men under 65 years of age and the second most common cause in women. These facts force us to revisit cardiovascular disease and consider new strategies for prediction, prevention, and treatment.
7,551 citations
TL;DR: Employing a consensus approach, the working team critically considered the available evidence and multinational expert criticism, revised the Rome II diagnostic criteria for the functional bowel disorders, and updated diagnosis and treatment recommendations.
4,302 citations