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Biomedical subjects

B Zuckerman

Publications and source records attributed to B Zuckerman.

At least 19 recordsLinked to original sources

Familial aggregation of blood pressure in a rural Chinese community.

This study investigated blood pressure in 1,183 Chinese nuclear families (mother, father, and first two children) via a cross-sectional 1994-1997 survey. The mother's, the father's, and the first sibling's blood pressures were each significantly and independently related to the second sibling's blood pressure after adjustment for sex, age, height, weight, education, smoking, and alcohol consumption. The association was consistent across the four age strata (6-10, 11-14, 15-19, and > or = 20 years). The rate of high systolic blood pressure in the second sibling was lowest (2.3%) when both parents and the first sibling were in the low blood pressure tertile (low-low group) and highest (26.0%) when these family members were in the high blood pressure tertile (high-high group). The rate was intermediate if only the parents (10.7%, high-low group) or the first sibling (8.4%, low-high group) was in the high blood pressure tertile. As compared with the low-low group, the odds ratios for the high-high, high-low, and low-high groups were 14.3 (95% confidence interval 4.3-48.2), 4.3 (95% confidence interval 1.2-15.6), and 3.9 (95% confidence interval 1.1-14.4), respectively. A similar pattern was found for diastolic blood pressure. The data indicate a strong familial aggregation of blood pressure in this population and show that such a familial influence on blood pressure can be detected from early childhood onward.

Adolescent

Blood pressure at age 3-24 years in a rural community in Anhui, China.

PURPOSE: This community-based study in Anhui, China examined the sex-specific pattern of blood pressure (BP) and its major determinants between age 3 and 24 years. METHODS: BP, height, weight, and related covariates were obtained from all eligible subjects by consistent methods. A generalized additive model was used to explore independent relations between BP and covariates. The sample for analyses included a total of 14,277 subjects (7244 males and 7033 females). RESULTS: Systolic blood pressure (SBP) increased linearly with age to an apparent plateau around the age of 15 years in girls and 20 years in boys. Diastolic blood pressure (DBP) essentially paralleled SBP. Until the age of 10, both SBP and DBP were similar in boys and girls; thereafter, values for boys surpassed those for girls with an average difference of 9 mmHg and 4 mmHg for SBP and DBP, respectively, at 20 years of age. This sex difference appeared to persist into early adulthood. The independent relation between BP and each of the three major determinants (age, height, and weight) was nonlinear over the age range studied. Sex-specific regression models with linear terms for age, height and weight were developed for each of four age groups (3-9, 10-14, 15-19, 20-24 years). The 5th, 10th, 90th, and 95th percentiles based on the percentage of predicted values can serve as the cutoffs for low, normal-low, normal-high, and high BP. The predicted values were derived from the above regression models that take into account an individual's sex, age, height, and weight. CONCLUSIONS: This analysis provided important basis for classification of hypertension status and subsequent investigation of environmental risk factors in this population.

Adolescent

Blood pressure in children exposed prenatally to cocaine.

Prenatal exposure to cocaine may alter autonomic nervous system function resulting in hypertension. Blood pressure was measured oscillometrically in a convenience sample of cocaine-exposed (n = 32) and nonexposed (n = 23) children, aged 8 to 26 months, by examiners unaware of exposure status. The exposed and nonexposed groups did not differ in systolic pressure (mean +/- SD 102.3 +/- 9.9 mmHg vs 119.1 +/- 19.4). Prenatal exposure to cocaine does not appear to be associated with elevated blood pressure in young children.

Autonomic Nervous System

X-ray and molecular emission from the nearest region of recent star formation.

The isolated, young, sunlike star TW Hya and four other young stars in its vicinity are strong x-ray sources. Their similar x-ray and optical properties indicate that the stars make up a physical association that is on the order of 20 million years old and that lies between about 40 and 60 parsecs (between about 130 and 200 light years) from Earth. TW Hya itself displays circumstellar CO, HCN, CN, and HCO+ emission. These molecules probably orbit the star in a solar-system-sized disk viewed more or less face-on, whereas the star is likely viewed pole-on. Being at least three times closer to Earth than any well-studied region of star formation, the TW Hya Association serves as a test-bed for the study of x-ray emission from young stars and the formation of planetary systems around sunlike stars.

Astronomical Phenomena

Violence-related injuries in a pediatric emergency department.

BACKGROUND: Since the 1980s, violence has emerged as a leading public health concern in the United States. Recent studies have begun to address the impact of interpersonal violence specifically on young children. The purpose of this study was to describe the epidemiology of violence-related injuries (VRI) in an urban pediatric emergency department (ED). METHODS: A six-month retrospective chart review was conducted. The records of 11,000 patients 17 years of age and younger who were seen in an urban pediatric ED were accessed for VRI. VRI were defined as purposefully inflicted with intent to harm. Patients discharged from the ED with VRI were compared to patients admitted with VRI. RESULTS: Three hundred seventeen (3%) of patients were categorized as having VRI during the six-month study period. Eighty-three percent were discharged, and 17% were admitted. The majority of injuries was the result of interpersonal conflict with a friend or acquaintance. Patients discharged were more likely to involve: younger children, female victims, and blunt instruments. Thirteen percent of discharged patients, however, involved potentially lethal weapons (knife or firearm). CONCLUSIONS: The vast majority of patients with VRI are discharged from the ED. Females and young children were frequently evaluated for VRI in the pediatric ED. Identification of these patients can be used to initiate service protocols directed at violence prevention.

Adolescent

Elevated plasma norepinephrine after in utero exposure to cocaine and marijuana.

OBJECTIVE: To compare plasma catecholamine concentrations between cocaine-exposed and unexposed term newborns and to determine the relationship between plasma catecholamines and newborn behavior. METHODS: Forty-six newborn infants participating in a prospective study of the neonatal and long-term effects of prenatal cocaine exposure were studied. Based on maternal self-report, maternal urine screening, and infant meconium analysis, 24 infants were classified as cocaine-exposed and 22 as unexposed. Between 24 and 72 hours postpartum, plasma samples for norepinephrine (NE), epinephrine, dopamine, and dihydroxyphenylalanine analysis were obtained. The Neonatal Behavioral Assessment Scale was administered at 1 to 3 days of age and at 2 weeks of age by examiners masked to the drug exposure status of the newborns. RESULTS: The cocaine-exposed newborns had increased plasma NE concentrations when compared to the unexposed infants (geometric mean, 923 pg/mL vs 667 pg/mL). There were no significant differences in plasma epinephrine, dopamine, or dihydroxyphenylalanine concentrations. Analysis for the effect of potential confounding variables revealed that maternal marijuana use was also associated with increased plasma NE, although birth weight, gender, and maternal use of alcohol or cigarettes were not. Geometric mean plasma NE was 1164 pg/mL in those infants with in utero exposure to both cocaine and marijuana compared to 812 pg/mL in those exposed to only cocaine and 667 pg/mL in those exposed to neither. Among the cocaine-exposed infants, plasma NE concentration correlated with an increased score for the depressed cluster (r = .53) and a decreased score for the orientation cluster (r = -.43) of the Neonatal Behavioral Assessment Scale administered at 1 to 3 days of age. Adjusting for marijuana exposure had no effect on these relationships between plasma NE and the depressed and orientation clusters. CONCLUSION: Plasma NE is increased in newborns exposed to cocaine and marijuana. Increased plasma NE is associated with selected neurobehavioral disturbances among cocaine exposed infants at 1 to 3 days of life but not at 2 weeks.

Cannabis

Association between child behavior problems and frequent physician visits.

OBJECTIVE: To determine the association between parent-reported behavior problems and health care utilization, especially among physically healthy children. DESIGN: Analysis of data from the 1988 National Health Interviews Survey--Child Health Supplement. The sample for analysis consisted of 11,840 children aged 5 to 17 years. The independent measure of primary interest are behavior problems as measured by the Behavior Problems Index. For the bivariate analysis, children in the lowest quartile, highest quartile and middle half were compared. For the multivariate analysis, children in the highest quartile with behavior problems were compared with all other children. MAIN OUTCOME MEASURES: The number of reported physician visits in the past year and the past 2 weeks, Two common behavior syndromes--antisocial and depressed or anxious--were analyzed separately to determine whether a specific type of behavior problem was associated with frequent health care utilization. RESULTS: Eighteen percent of the children aged 5 to 17 years had four or more health visits during the past year, and 2% had two or more visits during the past 2 weeks. Children in the top quartile for parent-reported behavior problems were more likely to have four or more physician visits than children in the middle half and bottom quartile. Children reported to be in "excellent," "very good," or "good" health who were in the top quartile of behavior problems were more likely to report four or more physician visits during the past year, but no statistically significant differences were seen among children reported to be in "fair" or "poor" health. Controlling for confounding variables, children in the top quartile of the Behavior Problems Index are significantly more likely to report four or more visits during the past year and two or more visits during the past 2 weeks compared with other children. Anxious or depressed and antisocial subscales of the Behavior Problems Index showed independent and significant associations with four or more physician visits in the past year. CONCLUSION: Children with parent-reported behavior problems are likely to have more frequent physician visits compared with children without behavior problems, even when confounding sociodemographic and health status variables are controlled. The association is concentrated among physically healthy children.

Adolescent

Persistence of pediatric post traumatic stress disorder after 2 years.

One-hundred and fifty-six children were randomly evaluated at an inner-city juvenile/family court. These children were removed from their parent's custody subsequent to a finding of severe child maltreatment. From our original sample of 156 children, 62 met strict criteria for Post Traumatic Stress Disorder (PTSD). Fifty-two of these 62 were successfully recruited and participated in the 2 year re-examination. Each PTSD diagnosis was conferred by the Diagnostic Interview for Children and Adolescents (DICA). From our sample of 52 PTSD children re-examined after 2 years, 17 (32.7%) retained the full PTSD diagnosis, while 67.3% did not meet criteria.

Adolescent

Late dose-response effects of prenatal cocaine exposure on newborn neurobehavioral performance.

OBJECTIVE: To determine in a representative sample of full-term urban newborns of English-speaking mothers whether an immediate or late dose-response effect could be demonstrated between prenatal cocaine exposure and newborn neurobehavioral performance, controlling for confounding factors. METHODS: The Neonatal Behavioral Assessment Scale (NBAS) was administered by masked examiners to a total sample of 251 clinically healthy, full-term infants at 2 days and/or 17 days. Three in utero cocaine exposure groups were defined: heavily exposed (n = 44, > 75th percentile self-reported days of use during pregnancy and/or > 75th percentile of meconium benzoylecognine concentration); lightly exposed (n = 79, less than both 75th percentiles); and unexposed (n = 101, no positive biological or self-report marker). At the 3-week examination there were 38 heavily exposed, 73 lightly exposed, and 94 unexposed infants. Controlling for infant birth weight, gestational age, infant age at the time of examination, mothers' age, perinatal risk, obstetric medication, and alcohol, marijuana, and cigarette use, a regression analysis evaluated the effects of levels of cocaine exposure on NBAS performance. RESULTS: No neurobehavioral effects of exposure on the newborn NBAS cluster scores or on the qualifier scores were found when confounders were controlled for at 2 to 3 days of age. At 3 weeks, after controlling for covariates, a significant dose effect was observed, with heavily exposed infants showing poorer state regulation and greater excitability. CONCLUSIONS: These findings demonstrate specific dose-related effects of cocaine on 3-week neurobehavioral performance, particularly for the regulation of arousal, which was not observed in the first few days of life.

Cannabis

Drug effects: a search for outcomes.

In order to best understand the developmental and behavioral effects of prenatal cocaine exposure, two important activities must occur. The first is the continuing development and refinement of research methodologies. Information-sharing activities such as conferences support this goal. Second, agencies such as NIDA need to support longitudinal followup of prenatally drug-exposed child cohorts and controls to identify outcomes beyond infancy and toddler years. Without support for information exchange and longitudinal followup, researchers will still be in the dark regarding the effects of prenatal drug exposure on school functioning when the next drug epidemic occurs. This message was not heeded in the 1970s and early 1980s, leaving researchers in the 1990s in the uncomfortable position of saying they do not know the longer term effects of prenatal drug exposure.

Animals

Familial aggregation of low birth weight among whites and blacks in the United States.

BACKGROUND: Studies have shown that the birth weight of infants is correlated with the birth weights of their siblings and their mothers. We investigated whether the birth weights of mothers and index children were jointly associated with the risk of low birth weight in the siblings of the index children. METHODS: We used data on the live-birth cohort of the 1988 National Maternal and Infant Health Survey. The analysis included 1691 white and 1461 black mothers, each of whom had two or more live-born, singleton children. Multiple logistic regression with generalized-estimation equations was used to assess the risk of low birth weight among an index child's siblings. Four groups were studied: that in which neither the mother nor the index child had low birth weight (group 1), that in which only the mother had low birth weight (group 2), that in which only the index child had low birth weight (group 3), and that in which both the mother and the index child had low birth weight (group 4). There was adjustment for other maternal and infant covariates. RESULTS: Among white siblings in groups 1, 2, 3, and 4, 3.6, 8.3, 21.2, and 38.9 percent, respectively, had low birth weight, as compared with 8.0, 19.0, 31.1, and 57.1 percent of black siblings. When group 1 was used as the reference group, the adjusted odds ratios (and 95 percent confidence intervals) for low birth weight in groups 2, 3, and 4 were 2.5 (1.4 to 4.3), 6.8 (4.7 to 9.8), and 15.4 (9.2 to 25.5), respectively, among white siblings and 2.6 (1.8 to 3.8), 4.7 (3.5 to 6.4), and 13.9 (9.2 to 20.9) among black siblings. These associations were consistently found for birth weights below 1500 g and those ranging from 1500 to 2499 g in both races and after stratification for the mother's age, parity, education, cigarette-smoking status, and weight and height before pregnancy and the infant's sex. CONCLUSIONS: Although selection and recall biases cannot be excluded with certainty, our data suggest a strong familial aggregation of low birth weight among both whites and blacks in the United States.

Black or African American

Inhibition of giant-planet formation by rapid gas depletion around young stars.

Although stars form from clouds of gas and dust, there are insignificant amounts of gas around ordinary (Sun-like) stars. This suggests that hydrogen and helium, the primary constituents of planets such as Jupiter and Saturn, are not easily retained in orbit as a star matures. The gas-giant planets in the Solar System must therefore have formed rapidly. Models of their formation generally suggest that a solid core formed in < or = 10(6) yr, followed by the accretion of the massive gaseous envelope in approximately 10(7) yr (refs 1-5). But how and when the gas of the solar nebula dissipated, and how this compares with the predicted timescale of gas-giant formation, remains unclear, in part because direct observations of circumstellar gas have been made only for stars either younger or older than the critical range of 10(6)-10(7) yr (refs 8-15). Here we report observations of the molecular gas surrounding 20 stars whose ages are likely to be in this range. The gas dissipates rapidly; after a few million years the mass remaining is typically much less than the mass of Jupiter. Thus, if gas-giant planets are common in the Galaxy, they must form even more quickly than present models suggest.

Extraterrestrial Environment

Relation between meconium concentration of the cocaine metabolite benzoylecgonine and fetal growth.

Among 95 term infants with benzoylecgonine, the cocaine metabolite, detectable in their meconium, there was an inverse relation between the concentration of benzoylecgonine and birth weight, length, and head circumference. Multiple regression analysis confirmed these relations after controlling for gestational age and maternal use of marijuana, cigarettes, and alcohol. These data suggest a dose-response relation between the magnitude of prenatal cocaine exposure and impaired fetal growth.

Birth Weight