The UCLA population studies of chronic obstructive respiratory disease. II. Determination of reliability and estimation of sensitivity and specificity.
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Adolescent↗
Biomedical subjects
A H Coulson
Publications and source records attributed to A H Coulson.
The UCLA population studies of chronic obstructive respiratory disease. I. Methodology and comparison of lung function in areas of high and low pollution.
The prevalence of symptoms of chronic obstructive respiratory disease and of functional respiratory impairment was determined in 3465 residents (70 per cent of enumerated) of an area historically exposed to photochemical/oxidant pollutants and 4509 residents (79 per cent of enumerated) of an area exposed to low levels of chemical pollutants. Tests administered included the NHLI questionnaire, electronic volume spirometry, whole body plethysmography, and the single-breath nitrogen test (deltaN2750-1250 and closing volume). Cough and cough with sputum were more frequently reported in the low-pollution area. Lung function was better among residents of the low-pollution area according to FEV1, FVC, maximal expiratory flow rates, closing volume fraction, thoracic gas volume, and airway resistance. Maximal mid-expiratory flow rate, considered to be a sensitive spirometric test for detection of small airways disease, was similar in residents of both areas. Mean deltaN2750-1250 was slightly worse among residents of the low-pollution area. Findings suggest that adverse effects of long-term exposure to photochemical/oxidant pollutants may occur primarily in the larger airways both among smokers and never smokers. The greatest differences between areas were observed in residents 18-59 years of age, suggesting that long-term exposure may be required to cause measurable impairment and that these differnces may be obliterated by such factors as smoking, differential out-migration and differential survival.
Adolescent↗
HLA types and immunity in multiple sclerosis.
HLA types and levels of humoral and cell-mediated immune responses to several antigens were studied in a large group of patients with multiple sclerosis, and in controls. Patients were more likely than controls to have the DRw2 antigen. They had higher mean antibody titers to measles but not to cytomegalovirus, herpes 1, or herpes 2, and had less competent cell-mediated responses. Antibody titers to measles were lower and cell-mediated immune responses were more effective in patients with the DRw2 antigen in patients than in patients without it. This apparent specificity for measles suggests that the etiology of multiple sclerosis is related to the immune response to measles or related viruses.
Antibodies, Viral↗
Comparison of placebo, nitroglycerin, and isosorbide dinitrate for effectiveness of relief of angina and duration of action.
Each of 13 patients with angina had either chewable isosorbide dinitrate, nitroglycerin (sublingual therapy), or placebo administered on each of three different days when mild anginal pain had been induced by walking on a treadmill. Both therapy with isosorbide dinitrate and therapy with nitroglycerin were effective in bringing about complete relief of the angina in less than ten minutes of uninterrupted continuous walking on the treadmill in 11 of the 13 subjects, while administration of placebo afforded complete relief in none. The duration of action of the drug was determined by following the first effort (during which the tested drug was given) by successive ten-minute walks at the same workload that first induced anginal pain. Half-hour resting periods separated the repeated periods of exercise, and the duration of action was taken to be the time from administration of the agent to the return of angina on one of the repetitive efforts. No prolonged protection was afforded by administration of the placebo. Nitroglycerin protected for slightly longer than one hour, while isosorbide dinitrate protected for 2 1/2 to 3 hours.
Aged↗
Ischemic heart disease. Precarious coronary lesions and prognosis.
Coronary arteriograms in 113 patients whose cases were followed for 2 to 12 years were analyzed in an attempt to discover why in some patients with angina pectoris there are long stable clinical courses and in others the courses proceed rapidly to death. It was found that patients with completed coronary occlusions, usually with distal portions reconstituted by collateral, had favorable prognoses with prolonged longevity. Patients with multiple high grade narrowings of the coronary arteries, on the other hand, had poor prognoses with high attrition rates. The more stenotic lesions present in the coronary arteries, the higher the attrition rates. Completed coronary occlusions, therefore, have been classified as nonprecarious while local coronary stenoses greater than 50 percent of the lumen diameter have been classified as degrees of precariousness according to the number of lesions present. When compared with classification by number of diseased vessels and by arteriographic score of Friesinger, the nonprecarious cases had better prognoses than the precarious.
Adult↗
Nutrient estimates from computerized questionnaires vs. 24-hr. recall interviews.
A computerized nutritional assessment service used by dentists was investigated. Daily nutrient intake of forty-six adult subjects was estimated from replies to a computerized food frequency questionnaire and the results compared with the average nutrient intakes of the same individuals obtained during five 24-hr. dietary recall interviews. Although the two methods produced essentially the same mean for carbohydrate intake and a minimal difference in the mean caloric values, mean estimates of the other nutrients were 6 to 88 per cent greater with the computerized data than via the dietary recalls. The dietary assessment service included unwarranted recommendations for vitamin and mineral supplementation.
Adult↗
Multiple sclerosis and age at migration.
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Adolescent↗
Evidence for lower susceptibility to multiple sclerosis in Japanese-Americans.
A search for cases of multiple sclerosis (MS) was carried out among the 120,066 Japanese-American residents and the 3,060,366 Caucasian residents native to state of residence in King and Pierce Counties, Washington, and Los Angeles County, California. Although 48 cases would have been expected among Japanese-Americans in both areas (on the basis of the prevalence among Caucasians in these two areas), only eight cases were found who were residents on prevalence day -- all were American-born residents of Los Angeles County. The age-, sex-adjusted prevalence of MS among Japanese-Americans in both areas was 5.9 per 100,000. The lower prevalence of multiple sclerosis among Japanese-Americans than among Caucasians has been interpreted as evidence of a lower susceptibility to factors causing multiple sclerosis.
Humans↗
Latitude, migration, and the prevalence of multiple sclerosis.
Prevalence of multiple sclerosis (MS) was determined in three groups of Caucasians in King and Pierce Counties (Washington) and in Los Angeles County (California): natives (born in study state), migrants from high-risk states (North), and migrants from low risk states (South). A diagnosis of definite or probable MS (excluding migrants with onset before migration) was established in 1816 of the persons found. The prevalence in Los Angeles County natives and in migrants from the South to either Los Angeles County or King-Pierce Counties were relatively low, while prevalence in King-Pierce Counties among natives and migrants from the North were high. The prevalence in migrants from the North to Los Angeles was intermediate. The results suggest that some degree of protection is provided to migrants by residence in low-prevalence areas, either early or later in life.
California↗
Pediatric automotive restraints, pediatricians, and the academy.
Over 70% of the 192 Southern California Academy pediatricians responding to a survey teach parents about pediatric automotive safety devices but less than 3% do so on every visit. To test two methods of increasing the frequency of teaching, these pediatricians were randomly assigned to either a mailing from the Academy's local chapter (mail group) or a brief presentation by a local pharmaceutical representative at his regular visit (interview group); a follow-up was conducted one month later by mail. Sixty-one percent of the mail group and 49% of the interview group claimed that their teaching on this subject had increased since the original contact. While this difference did not reach statistical significance, it was in the same direction as the preferences for sources of pediatric information expressed by both groups of pediatricians. A special letter from the Academy was ranked most effective and a visit from the pharmaceutical representative was judged least effective. Because of the magnitude of the problem, availability of a solution, proof that pediatricians can influence health behavior related to children and acknowledgment of the Academy's role in pediatric education, an appeal is made for an all-out campaign by the Academy and its members to promote use of appropriate pediatric automotive safety devices.
Accidents, Traffic↗