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Biomedical subjects

B Rosner

Publications and source records attributed to B Rosner.

At least 325 records · Page 18Linked to original sources

Risk factors for genetic typing and detection in retinitis pigmentosa.

An outpatient population with retinitis pigmentosa was evaluated with respect to best corrected visual acuity, cycloplegic refractive error, appearance of the lenses, presence or absence of bone spicule pigmentation, age of onset of night blindness by history, and presence or absence of a history of parental consanguinity. The population included 489 affected patients subdivided into the four following groups: 69 (14.1%) dominant, 67 (13.7%) autosomal recessive, 34 (7.0%) X-chromosome-linked, and 319 (65.2%) isolate. Contingency table and life table analyses showed that significant differences existed for these criteria among the various groups. An analysis based on data from 35 families showed significant differences with respect to best corrected visual acuity and cylindrical refractive error when comparing affected patients with their age-matched normal relatives. These findings support the idea that observations in a routine ocular examination can aid in genetic classification of affected patients and in selection of relatives of affected patients who are at higher risk for having early stages of retinitis pigmentosa.

Adolescent↗

Oral contraceptive use in relation to nonfatal myocardial infarction.

The relation of oral contraceptive (OC) use to the risk of hospitalization for myocardial infarction (MI) was evaluated among 121,964 US nurses who responded to a mail questionnaire. There were 156 women who reported having been hospitalized for MI before the menopause, and 23 (15%) were OC users at the time of the MI. Of 3120 controls matched to the cases for menopausal status at the time of the MI and for age, 304 (10%) were using OCs at the time of the MI. The apparent increase in the risk of MI for current OC users was not explained by cigarette smoking, hypertension, elevated cholesterol or other identified risk factors for MI. We estimated that OC use increased MI risk 1.8-fold overall and 2.8-fold among nonsmokers without other risk factors. The increase in risk attributable to the combined effect of current OC use, cigarette smoking and hypertension was considerably greater than what would be predicted from the sum of the separate effects of these factors.

Contraceptives, Oral↗

Family history of breast cancer as a risk indicator for the disease.

Family history of breast cancer was examined among 1159 women who themselves had breast cancer and among 11,590 control subjects in a retrospective case-control study conducted in 1976 among a sample of female nurses in the United States. Having a mother with breast cancer increased a woman's risk of developing the disease by 80%, while having a sister with such a history increased the risk by 150%. Adjustment for potential confounding variables by logistic regression analysis did not alter these estimates appreciably. Both these associations were stronger at younger ages of onset of cancer, and in a positive maternal history was correlated with a larger increase in risk in women who menstruated for more than 35 years.

Adult↗

Ventricular premature beats and coronary risk factors.

Of 10,119 men aged 35 to 57 years studied in the Multiple Risk Factor Intervention Trial (MRFIT), ventricular premature beats (VPBs) were more frequent among the 112 men who reported having previously had a myocardial infarction (MI) (22.3%) as well as among the 143 men with a history of diabetes mellitus (13.3%) than among the remaining 9864 (7.6%). There was no demonstrable association between VPBs and cholesterol or blood pressure levels, either overall or in various age groups. There was, however, a strongly positive relationship between VPBs and age (p less than 0.001). A positive association between VPBs and smoking was present which was statistically significant overall (risk ratio = 1.21, 95% confidence limits from 1.03 to 1.43), as well as in the age groups 35 to 39 years (1.74, 1.13 to 2.68) and 55 to 57 years (1.50, 1.01 to 2.22). This association, if confirmed, raises the question of whether VPBs offer a mechanism for the increased morbidity and mortality from coronary heart diseases among cigarette smokers compared with nonsmokers.

Adult↗

Persistent wheeze. Its relation to respiratory illness, cigarette smoking, and level of pulmonary function in a population sample of children.

In a study of early-life risk factors for the development of adult obstructive airway disease, respiratory symptoms, disease and smoking histories, and spirometry were obtained for 650 children 5 to 9 yr of age and their families in East Boston, Massachusetts. Persistent wheezing was the most frequently reported chronic symptom, occurring in 9.2% (60/650) of the population. Children with persistent wheezing were more likely to report cough and phlegm (p < 0.001), a history of asthma (p < 0.001), hay fever (p < 0.02), or past hospitalization with a respiratory illness (p < 0.001) than their asymptomatic peers. Prospective evaluation of a subsample of the 650 children confirmed a greater occurrence of acute lower respiratory illness in those children with persistent wheeze. Parental cigarette smoking was linearly related to the occurrence of persistent wheezing (p = 0.012) and lower degrees of mean normalized forced expiratory flow during the middle half of the forced vital capacity (FEF-Z score). A multiple linear regression identified the mother's current smoking status and current persistent wheeze as significant predictors of the children's mean FEF-Z score. Other variables, such as the father's smoking, children's personal smoking, a doctor's diagnosis of asthma, and a past history of lower respiratory illness were not significant predictors of the FEF-Z score.

Child↗

Characteristics of respondents and non-respondents to a mailed questionnaire.

In establishing a cohort of U.S. nurses, an assessment of response bias was made comparing respondents and non-respondents with regard to age, education, state of residence, employment status, field of employment, and major specialty. Overall, the 122,328 respondents (69.7 per cent) and 43,222 non-respondents were quite similar. Together with the reasonable response rate in a homogeneous population, this suggests that estimation of exposure-disease associations is unlikely to be affected by major bias due to non-response.

Adult↗

Effects of beer, wine, and liquor in coronary deaths.

For a series of 568 married men who died of coronary heart disease and an equal number of matched control subjects, information was collected on a large number of variables, including daily alcohol consumption classified by type of beverage, namely, beer, wine, or liquor. Daily consumption of small to moderate amounts of alcohol (2 oz [59.2mL] or less daily) was inversely related to coronary death. This inverse relation was present in both crude and adjusted matched-pair analyses and was similar for each type of alcohol, as indicated by adjusted relative risks of 0.3 for beer, 0.3 for wine, and 0.2 for liquor. In contrast, for heavy drinking, there was no association with coronary death in either crude or adjusted analyses.

Adult↗

Use of antimicrobial drugs in general hospitals: patterns of prophylaxis.

The patterns of prophylactic use of antimicrobial drugs were reviewed in 5288 charts drawn by a random method from 20 randomly selected short-stay general hospitals in Pennsylvania. About 10 per cent of hospitalized patients received antimicrobial drugs for prophylaxis in operations or nonsurgical procedures, and prophylaxis accounted for about 30 per cent of all antimicrobial drugs administered in hospitals. The drugs used most often for prophylaxis were cephalosporins, followed by benzyl penicillins, ampicillin and tetracyclines, in that order. Despite indications that prophylaxis, when useful at all, is effective only when given concurrently with and for 24 to 48 hours after operation, it was usually continued throughout hospitalization. Almost 80 per cent of prophylactic antimicrobial drugs were administered at least 48 hours after an operation or procedure -- suggesting that limiting prophylaxis to the first 24 to 48 hours, as currently recommended, would substantially reduce expenditures for antimicrobial drugs in hospitals.

Ampicillin↗

Chlamydia trachomatis in women: antibody in cervical secretions as a possible indicator of genital infection.

One hundred eighty-five women college students were examined for genital infection with Chlamydia trachomatis. This organism was isolated from nine (5%) of the 185 women. Antibody was demonstrated in the genital secretions of 26 (14%) and in the serum of 70 (38%) of the women. None of the sexually inexperienced women was infected. Among those sexually experienced, the prevalence of isolation of C. trachomatis and of detection of local antibodies in cervical secretions and serum antibodies to C. trachomatis increased in relation to the number of life-time sexual partners. Local antibody appeared to be a more reliable indicator of infection with C. trachomatis than serum antibody in this college population.

Adolescent↗

Use of antimicrobial drugs in general hospitals. I. Description of population and definition of methods.

The patterns of use of antimicrobial drugs in a random sample of general hosptials in Pennsylvania were studied. The sample was tested for validity, and all deaths and discharges were analyzed for 10 random days drawn across the year spanning July 1973 to June 1974. Methods were developed for abstracting the hospital records and for determining the reproducibility of the findings of the physician and nonphysician chart reviewers. More than 99% of the requested charts were available. In the 5,288 charts reviewed, most of the required data were readily available. The study population was 84% white and 58% female; most patients were in hospitals that had more than 300 beds and that were located in towns with populations of greater than 10,000. In 41% of the 2,070 antimicrobial courses administered to almost 30% of the patients, an explicit clinical statement of why the drug was being given could be found in the chart. The information for review was found in clinical charts, but in half of the charts, the information required was not on face sheets and discharge summaries.

Anti-Bacterial Agents↗

Use of antimicrobial drugs in general hospitals. II. Analysis of patterns of use.

The hospital charts were surveyed of 5,288 patients in 20 hospitals that were randomly selected from the 194 general hospitals in Pennsylvania. Antimicrobial drugs were administered to 28% of the patients, with little variation in pattern according to hospital size. Surgical services accounted for 61% of the patients who received antimicrobial drugs, and the proportion of patients receiving such drugs varied from 84% on thoracic and cardiovascular surgical services to 13% on obstetrical services. General medicine accounted for 29% of the patients who received antimicrobial drugs and pediatrics for 9%. Eight percent of the hospital population accounted for 50% of all antimicrobial drugs used. Ampicillin was the most frequently used drug, being given in 22% of all courses, with cephalosporins (18%), benzylpenicillins (14%), and tetracycline (13%) next in order. Approximately 30% of the antimicrobial courses were used for prophylaxis.

Anti-Bacterial Agents↗

Effect of parental cigarette smoking on the pulmonary function of children.

The authors have investigated the effects of parental smoking patterns on the pulmonary function of children in East Boston, Massachusetts. A crude inverse dose-response relationship was observed between the level of FEF25--75% predicted of children who never smoked and the number of smoking parents in the household. Compared to children with two non-smoking parents, the level of FEF25--75% predicted was 0.156 and 0.355 standard deviation units lower for children with one and two currently smoking parents, respectively. An additional decline in level of FEF25--75% predicted was observed for children who themselves had smoked. Smoking children with two smoking parents had an average FEF25--75% predicted level which was 0.355 standard deviation units lower than non-smoking children with two smoking parents. These data not only confirm that cigarette smoking by young children and teenagers has direct measurable effects on their pulmonary function, but also show that cigarette smoking by parents has a measurable effect on the pulmonary function of their children which is independent of any direct use of cigarettes by the children.

Child↗