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Biomedical subjects

B Rosner

Publications and source records attributed to B Rosner.

At least 253 records · Page 14Linked to original sources
PubMed1986

Effects of a low-fat diet on plasma lipoprotein levels.

Lowering the intake of fat to decrease serum cholesterol levels has unknown effects on the proportion of cholesterol in low-density lipoprotein (LDL) and high-density lipoprotein (HDL). Twenty normolipidemic nonvegetarians were given dietary instruction and supervision in a low-fat, semivegetarian diet for three months. Mean consumption of total fat, saturated fat, and cholesterol decreased, whereas intake of carbohydrate increased significantly on a low-fat diet. Plasma LDL levels decreased by 18% and HDL levels by 7% from prestudy baseline levels. The LDL/HDL ratio declined by 11%. Plasma triglyceride levels and body weight were unchanged. In individual subjects, the decrements in consumption of saturated fat and the increments in ingestion of polyunsaturated fat were each significantly correlated with decreases in LDL. One year after the subjects had returned to a self-selected diet, levels of dietary saturated fat and cholesterol and the plasma LDL/HDL ratio remained significantly below prestudy levels. This study and others suggest that a low-fat, high-carbohydrate diet favorably affects the plasma LDL/HDL proportion by decreasing LDL on a percentage basis 2 1/2 to three times more than it decreases HDL.

Adolescent↗
PubMed1985

A prospective study of postmenopausal estrogen therapy and coronary heart disease.

To clarify the possible role of postmenopausal estrogen use in coronary heart disease, we surveyed 121,964 female nurses, aged 30 to 55 years, with mailed questionnaires, beginning in 1976. Information on hormone use and other potential risk factors was updated and the incidence of coronary heart disease was ascertained through additional questionnaires in 1978 and 1980, with a 92.7 per cent follow-up. End points were documented by medical records. During 105,786 person-years of observation among 32,317 postmenopausal women who were initially free of coronary disease, 90 women had either nonfatal myocardial infarctions (65 cases) or fatal coronary heart disease (25 cases). As compared with the risk in women who had never used postmenopausal hormones, the age-adjusted relative risk of coronary disease in those who had ever used them was 0.5 (95 per cent confidence limits, 0.3 and 0.8; P = 0.007), and the risk in current users was 0.3 (95 per cent confidence limits, 0.2 and 0.6; P = 0.001). The relative risks were similar for fatal and nonfatal disease and were unaltered after adjustment for cigarette smoking, hypertension, diabetes, high cholesterol levels, a parental history of myocardial infarction, past use of oral contraceptives, and obesity. These data support the hypothesis that the postmenopausal use of estrogen reduces the risk of severe coronary heart disease.

Adult↗
PubMed1985

Plasma lipoprotein levels in vegetarians. The effect of ingestion of fats from dairy products.

The influence of dairy foods in the diet on plasma levels of total, low-density lipoprotein, and high-density lipoprotein cholesterol (TC, LDL-C, and HDL-C, respectively) was studied in 75 adult lactovegetarians living in the northeastern United States. Dairy products were the major sources of dietary saturated fat and cholesterol. The plasma TC level was positively correlated with dietary saturated fat and dietary cholesterol, and inversely correlated with the ratio of polyunsaturated to saturated fats in the diet. Correlations between the LDL-C level and the nutrients were similar to those of the TC level. The HDL-C level was not significantly related to any nutrients in the diet. The cholesterol levels of the lactovegetarians were compared with those of strict vegetarians. Lactovegetarians had 24% higher LDL-C levels and 7% higher HDL-C levels than strict vegetarians. Analysis within and among vegetarian populations suggests that ingestion of fatty dairy products raises the LDL-C level on a percentage basis about three times more than it raises the HDL-C level.

Adult↗
PubMed1985

Natural course of retinitis pigmentosa over a three-year interval.

Ninety-four patients, 6 to 49 years old, with progressive forms of retinitis pigmentosa were examined at baseline and annually for three consecutive years with respect to visual acuity, kinetic visual fields, dark-adaptation thresholds, computer-averaged electroretinograms, and fundus photographs. A subset was recalled within two months of a given visit to measure intervisit variability and to develop criteria for what constitutes significant (P less than .01) functional change. Over a three-year interval full-field electroretinograms declined significantly in 66 of 86 patients (77%) with detectable responses at baseline. Patients lost an average of 16% to 18.5% of remaining electroretinographic amplitude per year and 4.6% of remaining visual field area per year. Bone spicule pigmentation increased in 41 of 76 patients for whom we could make comparisons over a three-year interval (54%). Visual acuity and dark-adaptation thresholds remained relatively stable.

Adolescent↗
PubMed1985

Validity and reproducibility of the Cooperative Cataract Research Group (CCRG) cataract classification system.

The validity and reproducibility with which six classifiers [one experienced (L.T.C.), and five novices (W.G., F.G., W.W., J.W. and O.W.)] used the CCRG cataract classification system was assessed. The validity of index classifications was assessed by computing sensitivities and pairwise interclass correlations between experienced and novice classifiers using the former's classification as the standard. The number of unordered combinations of terms in the CCRG's classification was reduced by combining cortical terms according to the CCRG's accepted system of staged simplification. The number of combinations of terms at each stage is as follows: Stage I (greater than 1000); II (127); III (63); IV (15); V (7); VI and VII (3) and VIII (2). Excellent agreement was obtained between the experienced and novice classifiers for Stages VII and VIII of the classification, good agreement for Stages V and VI and poor agreement for Stages IV, III and II (sensitivities of 97, 96, 72, 59, 40, 24 and 20% respectively). Good agreement was also achieved for the classifications of single lenticular regions, except for subcapsular regions. The intra- and interobserver reproducibility was assessed by computing the Kappa statistic to (1) compare classifications between novice observers and (2) compare repeat classifications made by the same observer by viewing the same cataract once on each of three different days. The novice classifiers had excellent intraobserver reproducibility for Stages VII and VIII (Kappas of 0.87 and 0.97 respectively), good reproducibility for Stages IV, V and VI (Kappas of 0.53, 0.62 and 0.62, respectively) and marginal reproducibility for stages II and III (Kappas of 0.39 and 0.40, respectively). The intraobserver reproducibility of the experienced classifier was superior to the others for virtually all characteristics with excellent reproducibility for Stages IV, V, VI, VII and VIII with Kappas of 0.79, 0.90, 1.0, 1.0 and 1.0, respectively and good reproducibility for Stages II and III (Kappas of 0.55 and 0.64, respectively). These results indicate that the simplified CCRG cataract classification system (Stages IV-VIII) passes the minimum standards for reproducibility. The performance of the experienced classifier far exceeds the minimum standards and indicates the feasibility of improving classifier performance with training and practice.

Cataract↗
PubMed1985

Increased green and yellow vegetable intake and lowered cancer deaths in an elderly population.

In a prospective cohort study of 1271 Massachusetts residents 66 years of age or older, we examined the association between consumption of carotene-containing vegetables and subsequent five year mortality. Dietary information was obtained by food frequency questionnaire in 1976. The relative risk of cancer mortality was examined within quintiles of green and yellow vegetable score (calculated from intake of carrots or squash, tomatoes, salads or leafy vegetables, dried fruits, fresh strawberries or fresh melon, and broccoli or brussel sprouts). After controlling for age and smoking behavior, those in the highest quintile of intake of these carotene-containing vegetables had a risk of cancer mortality which was 0.3 (95% confidence limits 0.10-0.96) that of those in the lowest quintile. The trend of decreased cancer risk with increasing intake of carotene containing vegetables was significant (p = .026). This relationship is consistent with the hypothesis that carotene may act as an inhibitor of carcinogenesis.

Aged↗
PubMed1985

Infection with Chlamydia trachomatis in female college students.

Chlamydia trachomatis was isolated from genital specimens from 21 (4.9%) of 431 female college students. Antibody to C. trachomatis was found in the genital secretions of 52 (11.9%) of 437 women. Multiple logistic regression analysis showed race, number of sexual partners, and use of barrier methods of contraception to be predictive of infection with C. trachomatis. Logistic regression analysis found race, number of sexual partners, use of barrier methods of contraception, and presence of cervical erythema to be predictive of local chlamydial antibody. White participants were infected less often (12 of 388 (3.1%)) than black participants (9 of 43 (20.9%)) (p less than 0.001) and were less likely to have local chlamydial antibody. None of the sexually inexperienced women were infected or had local antibody. Among the sexually experienced women, chlamydial infection and local chlamydial antibody increased with increasing number of sexual partners only for women who were not using barrier methods of contraception. Sexually experienced women who used barrier methods of contraception (condom, diaphragm) were less likely to be infected (one of 105 (1.0%)) than were sexually experienced women who used other contraceptive measures or who did not use contraception (20 of 276 (7.2%)) (p = 0.031). Women who used barrier methods of contraception also were less likely to have local chlamydial antibody. Women with cervical erythema were more likely to have local chlamydial antibody (4 of 11 (36.4%)) than women without cervical erythema (48 of 426 (11.3%)). Vaginal colonization with other sexually transmitted microorganisms (Mycoplasma hominis, Ureaplasma urealyticum, Trichomonas vaginalis) was noted more often among women with chlamydial infection than among uninfected women.

Adult↗
PubMed1985

An investigation of bias in a study of nuclear shipyard workers.

The authors examined discrepant findings between a 1978 proportional mortality study and a 1981 cohort study of workers at the Portsmouth, New Hampshire, Naval Shipyard to determine whether the healthy worker effect, selection bias, or measurement bias could explain why only the proportional mortality study found excess cancer deaths among nuclear workers. Lower mortality from noncancer causes in nuclear workers (the healthy worker effect) partly accounted for the observed elevated cancer proportional mortality. More important, however, was measurement bias which occurred in the proportional mortality study when nuclear workers who had not died of cancer were misclassified as not being nuclear workers based on information from their next of kin, thereby creating a spurious association. Although the proportional mortality study was based on a small sample of all deaths occurring in the cohort, selection bias did not contribute materially to the discrepant results for total cancer deaths. With regard to leukemia, misclassification of occupation in the proportional mortality study and disagreement about cause of death accounted for some of the reported excess deaths.

Epidemiologic Methods↗
PubMed1985

Regression analysis of changes in blood pressure with oral contraceptive use.

Measurements of blood pressure were obtained on 2,673 women from East Boston, Massachusetts, an urban, working class neighborhood, in surveys conducted in both 1973 and 1976-1977. Of these, 927 women participated in a third survey in 1978. The women were 16 to 49 years of age in 1973, premenopausal throughout the study, and not on blood pressure medication. Regression analyses were performed of blood pressure change between the first and second as well as between the second and third surveys on initial blood pressure, age, weight, and patterns of oral contraceptive use. For systolic pressure the effect of starting oral contraceptive use was an increase of 4.1 mmHg (p less than 0.0001), while the effect of discontinuing use relative to continued use was a 4.4 mmHg decrease (p less than 0.0001). These changes were not affected by duration of use or time since last use among past users. For diastolic pressure the average effect of starting use between surveys was an insignificant 1.0 mmHg increase, but diastolic pressure level seemed to increase with duration of use (0.5 mmHg/year, p = 0.0009). The effect of discontinuing use relative to continued use was a drop of 2.7 mmHg in diastolic pressure (p = 0.0004), which was uninfluenced by time since last use.

Adolescent↗
PubMed1985

Reproducibility and validity of a semiquantitative food frequency questionnaire.

The aim of this study was to evaluate the reproducibility and validity of a 61-item semiquantitative food frequency questionnaire used in a large prospective study among women. This form was administered twice to 173 participants at an interval of approximately one year (1980-1981), and four one-week diet records for each subject were collected during that period. Intraclass correlation coefficients for nutrient intakes estimated by the one-week diet records (range = 0.41 for total vitamin A without supplements to 0.79 for vitamin B6 with supplements) were similar to those computed from the questionnaire (range = 0.49 for total vitamin A without supplements to 0.71 for sucrose), indicating that these methods were generally comparable with respect to reproducibility. With the exception of sucrose and total carbohydrate, nutrient intakes from the diet records tended to correlate more strongly with those computed from the questionnaire after adjustment for total caloric intake. Correlation coefficients between the mean calorie-adjusted intakes from the four one-week diet records and those from the questionnaire completed after the diet records ranged from 0.36 for vitamin A without supplements to 0.75 for vitamin C with supplements. Overall, 48% of subjects in the lowest quintile of calorie-adjusted intake computed from the diet records were also in the lowest questionnaire quintile, and 74% were in the lowest one of two questionnaire quintiles. Similarly, 49% of those in the highest diet record quintile were also in the highest questionnaire quintile, and 77% were in the highest one or two questionnaire quintiles. These data indicate that a simple self-administered dietary questionnaire can provide useful information about individual nutrient intakes over a one-year period.

Adult↗
PubMed1985

Relative weight and risk of breast cancer among premenopausal women.

Although higher relative weight is generally considered to increase the risk of breast cancer, several case-control studies have suggested that the reverse may be true among premenopausal women. The association between Quetelet's index (a measure of relative weight calculated as weight/height) and the subsequent incidence of breast cancer was therefore examined during four years of follow-up among a cohort of 121,964 US women who were 30-55 years of age in 1976. In contrast to women who had experienced natural menopause or bilateral oophorectomy, the incidence of breast cancer among premenopausal women decreased with higher levels of relative weight. Age-adjusted relative risks for increasing quintiles of Quetelet's index were 1.00, 0.90, 0.90, 0.73, and 0.66 (Mantel extension test for trend = -2.82, p = 0.005). This inverse association was not explained by known risk factors for breast cancer and was somewhat stronger when Quetelet's index was computed using reported weight at age 18 years. The excess incidence of breast cancer among lean premenopausal women, however, was limited to tumors that were less than 2.0 cm in diameter, were not associated with metastases to lymph nodes, and were well-differentiated. These findings suggest that the apparent excess risk of breast cancer among lean premenopausal women may result at least in part from easier, and thus earlier, diagnosis of less aggressive tumors.

Adult↗
PubMed1985

The relationship of various indices of heart size on chest x-ray to the 10-year incidence of hypertension. The Normative Aging Study.

A total of 598 males (aged 30-74 years) who had baseline (1961-1970) chest radiography and baseline blood pressure less than 140/90 mmHg were observed prospectively for 10 years. Subjects were participants of the Normative Aging Study, a longitudinal study on aging initiated in 1961 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Blood pressures were taken at five- and 10-year follow-up examinations. Multiple logistic regression analysis indicated that the long diameter of the heart (on posteroanterior film) and the cardiac depth (on lateral film) were statistically significant predictors of subsequent hypertension after controlling for baseline body mass index, systolic pressure, and diastolic pressure. A similar model considering various composite indices of heart size indicated that the heart volume was a statistically significant and independent predictor of hypertension. Thus, increases in heart size may precede and predict the development of sustained hypertension.

Adult↗
PubMed1985

Health experiences of operating room personnel.

In an attempt to evaluate health experiences of operating room personnel using previously published reports, the authors calculated summary relative risks (RRs) for each outcome under investigation by combining data from six studies. For each summary RR, they also calculated 95% confidence limits; when the range of the confidence interval excludes 1.0, the increased risk is statistically significant at the 0.05 level. The most consistent evidence was for spontaneous abortion among pregnant physicians and nurses who work in operating rooms, where the RR was 1.3 (95% confidence limits from 1.2 to 1.4). For liver disease there were statistically significant increased RRs among both men (1.6, 1.3-1.9) and women (1.5, 1.2-1.9), but these were based on smaller numbers of studies. Although the results of pooled analyses are suggestive, most studies of this issue have relied on voluntary responses and self-reported outcomes, so that response and/or recall bias could explain these findings. In addition, these investigations generally have examined working in operating rooms rather than actual exposure to anesthetic gases. Finally, there have been considerable improvements in operating room scavenging systems during the last decade. Thus, prospective cohort studies are needed to determine whether there is a relationship between current levels of occupational exposure to anesthetic gases and adverse outcomes, particularly spontaneous abortion and liver disease.

Abortion, Spontaneous↗
PubMed1985

Effect of cigarette smoking on the pulmonary function of children and adolescents.

The effect of personal cigarette smoking on the growth of lung function in children and adolescents has been assessed in a longitudinal study of a group of 669 subjects 5 to 19 yr of age at initial examination. Subjects were seen annually and assessed with standard questionnaires and measurements of forced expiratory volume in one second (FEV1) and forced expiratory flow during the middle half of the forced vital capacity (FEF25-75). Multiple regression analysis revealed that after correction for previous FEV1 or FEF25-75, age, sex, height, change in height, interactions of age and change in height, and sex and height, and mother's smoking, the personal smoking by the children led to a significant decrease in the rate of growth of FEV1 (p less than 0.001) and FEF25-75 (p = 0.033). On the basis of this analysis, it is estimated that, on average, children who begin to smoke at 15 yr of age and continue to smoke would achieve only 92% (95% confidence limit, 87 to 96%) of their expected FEV1 and 90% (95% confidence limit, 81 to 99%), of their expected FEF25-75 at 20 yr of age. These data suggest that relatively small amounts of cigarette use (median total consumption of 7,300 cigarettes in this study) by adolescents can lead to significant effects on the growth of lung function.

Adolescent↗
PubMed1985

Age, sex and gonadal influences on oestrogen receptor content in the rat liver.

Liver cytosol oestrogen receptor (OR) content of intact and gonadectomized male and female rats of defined age (1-18 months) was measured by the controlled pore glass bead assay. The OR content of animals of both sexes aged 3 weeks was low to insignificant (0.12 +/- 0.04 (S.E.M.) pmol/g wet wt liver). In the intact animal, liver OR reached maximum levels at an earlier age in the male (1.35 +/- 0.12 pmol/g at 28-32 weeks) than in the female (4.89 +/- 0.17 pmol/g at 44-52 weeks). In the mature female the OR is thus maintained at a level threefold greater than in males of comparable age. Levels of OR in the gonadectomized male tended to be higher, at all ages, than those in the intact male but this difference was not statistically significant. Ovariectomy was associated with a decreased OR content in rats aged less than 6 months and an increase in the older rats, but these effects (of ovariectomy) were not statistically significant. In the females, regression analysis of pooled data, combining all ages, indicated a significant positive correlation between OR and liver wet weight, independent of gonadal status; no such relationship was found with the males. The results indicate that factors influencing liver cytosol OR content include maturity, age and sex whereas the gonads have little obvious effect. These findings lend further support to the concept that sex differences exist in the liver.

Age Factors↗
PubMed1985

Epidemiology of neonatal hyperbilirubinemia.

Interview and record review data from 12,023 singleton deliveries were analyzed to determine the relationships between neonatal hyperbilirubinemia (10 mg/dL or greater) and maternal characteristics. Confounding variables were controlled by multiple logistic regression analysis. There was a statistically significant positive relationship between hyperbilirubinemia and low birth weight, Oriental race, premature rupture of membranes, breast-feeding, neonatal infection, use of the "pill" at time of conception, instrumental delivery, and history of first trimester bleeding. Maternal smoking and black race were negatively related to hyperbilirubinemia and statistically significant. In this study, other previously suspected etiologic factors such as epidural anesthesia, parity, use of oxytocin in labor, and white race were not associated with hyperbilirubinemia.

Adult↗
PubMed1984

Relation of serum vitamins A and E and carotenoids to the risk of cancer.

Epidemiologic studies suggest that low carotene intake and low levels of serum retinol may be associated with an increased risk of cancer. Likewise, in some animal studies vitamin E has been associated with a reduced rate of induced cancers. Therefore, we measured retinol, retinol-binding protein, vitamin E (alpha-tocopherol), and total carotenoids in serum collected in 1973 from 111 participants in the Hypertension Detection and Follow-up Program who were free of cancer at the time but were diagnosed as having cancer during the subsequent five years. These measurements were compared with those in 210 controls who were matched for age, sex, race, and time of blood collection, and who remained free of cancer. Mean values for retinol were similar for cases and controls (67.3 and 68.7 micrograms per deciliter, respectively [95 per cent confidence limits for case-control difference, -6.7 to 3.5]). Values were also similar for retinol-binding protein (6.01 and 5.94 mg per deciliter [-0.42 to 0.56]), and carotenoids (114.5 and 111.6 micrograms per deciliter [-9.1 to 15.9]). The mean base-line retinol level in the 18 subjects with subsequent lung cancer was higher than that in their matched controls (79.0 vs. 71.4 micrograms per deciliter, -4.9 to 19.7). Serum vitamin E levels were somewhat lower in subjects who later had cancer than in controls (1.16 and 1.26 mg per deciliter, -0.22 to 0.02), in part because of the confounding effect of serum cholesterol levels (when adjusted for lipid levels, the case-control difference was -0.05 mg per deciliter; -0.17 to 0.07). These data do not support hypotheses relating intake or serum levels of antioxidant vitamins to a reduced cancer risk.

Adult↗