Search PubMed⌕ Search

Biomedical subjects

A Caspi

Publications and source records attributed to A Caspi.

At least 91 records · Page 5Linked to original sources
PubMed1995

Plasma fibrinogen levels and their correlates in 6457 coronary heart disease patients. The Bezafibrate Infarction Prevention (BIP) Study.

The association between fibrinogen measured in healthy individuals and subsequent development of ischemic heart disease is well established, but studies reporting fibrinogen levels in coronary heart disease patients are scarce. Plasma fibrinogen was determined for 5729 men and 728 women (aged 45 to 74) with established coronary heart disease, screened for participation in the Bezafibrate Infarction Prevention study, with the following lipid profile at the time of the first screening visit: total serum cholesterol < or = 270 mg/dl, high density lipoprotein cholesterol < or = 45 mg/dl and triglyceride < or = 300 mg/dl. Increased age was associated with augmented plasma fibrinogen values. Age-adjusted fibrinogen levels were higher in women than in men. A direct association was found between mean fibrinogen levels and low density lipoprotein cholesterol. On the other hand, the correlation with high density lipoprotein cholesterol was inverse. Fibrinogen was also associated with body mass index, behavioral variables and severity of coronary heart disease. In a multivariable linear regression analysis performed, risk factors considered explained merely 6 and 4% of fibrinogen variation for men and women, respectively. Therefore, most of the fibrinogen level variability in coronary heart disease patients is accounted for by factors that remain to be established by further research.

Age Factors↗
PubMed1995

Labor and delivery complicated by acute mitral regurgitation due to ruptured chordae tendineae.

Acute mitral regurgitation due to ruptured chordae tendineae is a dramatic and life-threatening clinical situation. Rarely does this complication occur during pregnancy. We present a case of a 30-year-old woman in week 31 of her pregnancy who developed acute mitral regurgitation, secondary to bacterial endocarditis and ruptured chordae tendineae. This acute event resulted in preterm labor a few hours later. Delivery was uneventful and successful and was followed by open heart surgery 5 days later. A review of the literature on chordae tendineae rupture and resulting mitral regurgitation during pregnancy is presented.

Acute Disease↗
PubMed1995

Temperamental origins of child and adolescent behavior problems: from age three to age fifteen.

We assessed relations between early temperament and behavior problems across 12 years in an unselected sample of over 800 children. Temperament measures were drawn from behavior ratings made by examiners who observed children at ages 3, 5, 7, and 9. Factor analyses revealed 3 dimensions at each age: Lack of Control, Approach, and Sluggishness. Temperament dimensions at ages 3 and 5 were correlated in theoretically coherent ways with behavior problems that were independently evaluated by parents and teachers at ages 9 and 11, and by parents at ages 13 and 15. Lack of Control was more strongly associated with later externalizing behavior problems than with internalizing problems; Approach was associated with fewer internalizing problems among boys; and Sluggishness was weakly associated with both anxiety and inattention, especially among girls. Lack of Control and Sluggishness were also associated with fewer adolescent competencies. These results suggest that early temperament may have predictive specificity for the development of later psychopathology.

Adolescent↗
PubMed1995

Temperamental qualities at age three predict personality traits in young adulthood: longitudinal evidence from a birth cohort.

In an unselected sample of over 800 subjects we studied whether behavioral styles at age 3 are linked to personality traits at age 18. We identified 5 temperament groups (labeled Undercontrolled, Inhibited, Confident, Reserved, and Well-adjusted) based on behavioral ratings made by examiners when the children were 3. These groups were reassessed at 18, and their personality styles were measured with the self-report Multidimensional Personality Questionnaire. Results pointed to continuities across time. As young adults, Undercontrolled children scored high on measures of impulsivity, danger seeking, aggression, and interpersonal alienation; Inhibited children scored low on measures of impulsivity, danger seeking, aggression, and social potency; Confident children scored high on impulsivity; Reserved children scored low on social potency; and Well-adjusted children continued to exhibit normative behaviors.

Adolescent↗
PubMed1995

Differences in ischemic threshold and nitrate efficacy between normotensive and hypertensive patients with stable angina pectoris.

The coexistence of ischemic heart disease with hypertension makes antihypertensive therapy essential, since relief of hypertension may ameliorate the coronary disease. On the other hand, the effect of antianginal nitrate therapy in patients with stable angina pectoris and systemic arterial hypertension is not fully understood. This study assessed the effects of hypertension on the ischemic threshold and the time to moderate angina, measured as parameters of nitrate efficacy. In this double-blind, parallel-group study, 141 patients with stable angina pectoris were randomly assigned to receive 5 mg, 10 mg or 20 mg isosorbide-5-mononitrate or matching placebo bid for 21 days. Ninety-three normotensive and 48 hypertensive patients were compared with regard to the time to moderate anginal pain and the ischemic threshold before and after nitrate treatment on the first day of the study. The acute nitrate effect 2 h after drug administration was substantially attenuated in hypertensives at both 10 and 20 mg of isosorbide-5-mononitrate, with the time to moderate anginal pain being significantly shortened. Impaired vasodilatator response of the arterial vasculature to organic nitrates, probably due to impaired biotransformation of organic nitrates to nitric oxide in hypertensive patients, is suggested as a possible mechanism for the diminished nitrate effect. Thus, oral nitrate therapy does not have the same beneficial antianginal effect in hypertensive patients as it does in normotensives. Dose adjustment based on the pretreatment blood pressure, and the administration of higher doses of oral nitrates should therefore be considered in hypertensive patients suffering from stable angina pectoris.

Aged↗
PubMed1995

Case report: multiple myeloma presenting as a diastolic heart failure with no evidence of amyloidosis.

The development of severe right sided congestive heart failure led to a diagnosis of immunoglobulin G (lambda) myeloma with a predominance of light chains. Cardiac catheterization and endomyocardial biopsy showed a severe diastolic dysfunction of both right and left ventricles and extensive myocardial infiltration by intercellular fibrillar tissue, which was not amyloid. This is a rare presentation of immunoglobulin deposition disease associated with immunocytic dyscrasias.

Amyloidosis↗
PubMed1994

Measuring impulsivity and examining its relationship to delinquency.

A multimethod, multisource assessment of impulsivity was conducted in a sample of more than 400 boys who were members of a longitudinal study of the development of antisocial behavior. Exploratory and confirmatory factor analysis of the 11 different impulsivity measures revealed two impulsivity factors: Cognitive and Behavioral. Cognitive and behavioral impulsivity had similar correlations with socioeconomic status. Cognitive impulsivity was more strongly related to IQ than was behavioral impulsivity. Behavioral impulsivity was more strongly related to delinquency at ages 10 and 12-13 than was cognitive impulsivity. Consistent with theoretical prediction, our results also indicate that behavioral impulsivity was especially related to serious delinquency that is stable over time.

Adolescent↗
PubMed1994

Personality traits are linked to crime among men and women: evidence from a birth cohort.

Is there a relationship between personality and criminal behavior? We addressed this question in a representative birth cohort of 862 male and female 18-year-olds. Personality was assessed with the Multidimensional Personality Questionnaire (MPQ). The MPQ measures 10 relatively independent personality traits and was not designed to identify offenders. Delinquency was assessed via 3 data sources: self-reports, informant reports, and official records. Variable-centered analyses revealed that MPQ scales indexing negative emotionality and behavioral constraint were consistent predictors of delinquency across the 3 data sources. Person-centered analyses revealed that youths abstaining from delinquency were uniquely characterized by low interpersonal potency. Youths involved in extensive delinquency were uniquely characterized by feelings of alienation, lack of social closeness, and risk taking. Advances in understanding criminal behavior can be made through research that places the personality-delinquency link in a developmental context.

Adolescent↗
PubMed1994

[Isosorbide-5-mononitrate in angina pectoris: its efficacy and absence of tolerance and rebound with an eccentric type of administration].

UNLABELLED: 214 patients with angina pectoris were randomized to placebo or isosorbide-5-mononitrate (ISMN) rapid release 5, 10 or 20 mg b.i.d. at 8 a.m. and 3 p.m. Exercise tests were performed between 8 a.m. and 10 p.m., before and 2 and 7 h after each dose on days 2 and 14 and before and 2 h after the morning dose on days 7 and 21. All doses of ISMN increased exercise duration significantly more than placebo, and this effect lasted throughout most of the day. It was maximal (73 s; 24%) 2 h after the morning dose, slightly attenuated but still significant at 7 h, increased 2 h after the second dose and attenuated but still greater than with placebo at 7 h. The increase was even greater at 3 weeks (99 s; 29%), perhaps due to a training effect. Similar improvement was observed in other exercise parameters. There was no significant dose response. There were 100% more anginal attacks in the placebo than in the 20-mg treatment group. No rebound (assessed by comparing exercise duration before the morning dose between the groups) was observed. CONCLUSION: ISMN b.i.d. eccentrically has an antianginal effect throughout most of the day, peaking at 2 h. This effect is sustained during chronic therapy, without tolerance or rebound.

Adult↗
PubMed1994

The "little five": exploring the nomological network of the five-factor model of personality in adolescent boys.

The California Child Q-set (CCQ) was used to explore the structure of personality in early adolescence and to develop scales to measure the "Big Five" dimensions: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience. Mothers provided Q-sorts of 350 ethnically diverse boys between 12 and 13 years old. Analyses of the construct validity of the scales provided a nomological network relating the Big Five to theoretically and socially important criterion variables, such as juvenile delinquency, Externalizing and Internalizing disorders of childhood psychopathology, school performance, IQ, SES, and race. These effects were obtained using diverse methods, including self-reports from the boys, ratings by their mothers and their teachers, and objective-test data. In addition to the Big Five, analyses also suggested 2 possibly age-specific dimensions of personality in early adolescence. Discussion is focused on the changing manifestations of personality traits throughout development.

Achievement↗
PubMed1993

Rationale and design of a secondary prevention trial of increasing serum high-density lipoprotein cholesterol and reducing triglycerides in patients with clinically manifest atherosclerotic heart disease (the Bezafibrate Infarction Prevention Trial).

Controlled clinical trials have demonstrated the efficacy of reducing the blood levels of low-density lipoprotein cholesterol in reducing the incidence of coronary artery disease in hypercholesterolemic middle-aged men. However, a similar reversibility of the risk of coronary artery disease has not been demonstrated for high-density lipoprotein cholesterol elevation and triglyceride reduction. Therefore, the effect of administering 400 mg of bezafibrate retard daily versus placebo (double blind) to patients with myocardial infarction preceding randomization by 6 months to 5 years, or a clinically manifest anginal syndrome documented by objective evidence of dynamic myocardial ischemia, or both, is being investigated. Three thousand subjects (aged 45 to 74 years) are being enrolled from 19 cardiac departments in Israel, with total serum cholesterol between 180 and 250 mg/dl, high-density lipoprotein cholesterol < or = 45 mg/dl and triglycerides < or = 300 mg/dl. In addition, low-density lipoprotein cholesterol concentrations are required to be < or = 180 mg/dl (< or = 160 mg/dl for patients aged < 50 years). Patients needing lipid-modifying therapy, exhibiting > or = 1 prespecified exclusion criterion or not giving informed consent, or a combination, are not randomized. The primary end points for evaluating efficacy are the incidence of fatal and nonfatal myocardial infarction, and sudden death. The hypothesized effect of bezafibrate administration under the aforementioned protocol is to reduce an estimated cumulative end point event incidence of > or = 15% by 20 to 25% over an average follow-up period of 6.25 years, through early 1998, when the last patient recruited will have completed 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Giant left main pseudoaneurysm obstructing the left anterior descending coronary artery demonstrated by transesophageal echocardiography and coronary angiography.

Left main pseudoaneurysm is a rare angiographic finding in young adults. We describe a 23-year-old male who presented with an acute anterior wall myocardial infarction. Coronary angiography and transesophageal echocardiography reveal a huge aneurysm of the distal left main obstructing the left anterior descending artery (LAD), which was defined by history as a pseudoaneurysm. The pseudoaneurysm was successfully resected and mammary artery was used to repair the distal left main and to bypass the LAD.

Adult↗
PubMed1993

Successful delivery following myocardial ischemia during the second trimester of pregnancy.

Acute myocardial infarction during pregnancy is considered to be associated with approximately 50% mortality of both mother and fetus. However, there are not enough data regarding the role of acute myocardial ischemia. We present a 36-year-old, pregnant, white female who was admitted twice at 18 and 20 weeks of gestation with acute myocardial ischemia. Cardiac catheterization revealed 70-80% stenosis of the mid left anterior descending artery (LAD) with normal antegrade flow and very good retrograde filling of the LAD from distal collaterals of the right coronary artery. Therefore, due to angiographic suggestion of protected LAD territory, we recommended medical therapy and scheduled a vaginal delivery that was successfully completed without cardiovascular complications. A stress thallium test performed 6 months later was normal, supporting our clinical judgment. In conclusion, every case of a pregnant woman with coronary insufficiency should be treated according to individual coronary anatomy and blood supply to the territory of the diseased artery, and should not be based on the old data in the literature. The decision for revascularization prior to delivery versus medical therapy, or Caesarean section versus natural delivery, should be made by a team of a cardiologist and an obstetrician.

Acute Disease↗
PubMed1993

Complete atrioventricular block complicating inferior acute wall myocardial infarction: short- and long-term prognosis.

The incidence of complete atrioventricular block (AVB) in a large group of patients with Q-wave inferior acute myocardial infarction (AMI) was 251 (11%) of 2273 patients. This incidence was significantly higher in women (14%) and patients > 70 years old (15%) than in men and patients < 70 years old (10% and 9%, respectively). Patients with complete AVB exhibited more serious arrhythmic and mechanical complications during hospitalization and included more patients with very high enzyme levels than their counterparts without AVB. The in-hospital mortality rate was 92 (37%) of 251 patients with complete AVB versus 200 (11%) of 1890 in those without AVB (p < 0.0001). After adjustment for age, gender, and important anamnestic, medical, and enzymatic findings, complete AVB emerged as an independent predictor of in-hospital mortality, yielding an odds ratio of 2.0 (90% confidence interval 1.12 to 3.57). The long-term (5-year) mortality rate in hospital survivors was slightly but not significantly higher in patients with complete AVB (28%) during hospitalization than in their counterparts with no AVB (23%). In view of these data, patients with inferior AMI in whom complete AVB develops are at increased risk and may benefit from urgent revascularization; the postdischarge management of survivors with complete AVB should be no different from that of patients without AVB.

Aged↗