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Biomedical subjects

C M Beard

Publications and source records attributed to C M Beard.

At least 55 records · Page 3Linked to original sources

The incidence of Peyronie's disease in Rochester, Minnesota, 1950 through 1984.

Peyronie's disease was diagnosed in 101 male residents of Rochester, Minnesota between 1950 and 1984. Mean patient age at diagnosis was 53 years. The average age-adjusted annual incidence rate of 25.7 and a prevalence rate of 388.6 per 100,000 male population were noted. The steady increase in incidence with time may reflect an increasing tendency to obtain medical help. However, the possibility of a true increase in the incidence rate cannot be ruled out. An effort was made to identify possible risk factors and other disease associations. Rheumatoid arthritis and hypertension were more common among the patients compared to the Rochester population. In contrast, no excess of diabetes mellitus was observed among patients with Peyronie's disease.

Adult↗

Malignant potential of the cryptorchid testis.

A follow-up study of 224 male patients from Rochester, Minnesota, diagnosed with cryptorchidism during the period from 1935 through 1974 was conducted to assess the frequency of subsequent testicular neoplasms. Age-specific rates for testicular neoplasm in this community were used to estimate an expected number for comparison with that observed. Two malignant testicular neoplasms have occurred in this cohort; thus, the standardized morbidity ratio was 11.4 (95% confidence interval, 1.4 to 41.1). Of the 158 patients born in the community, 11% were known to have birth weights of less than 2,500 g, approximately twice the expected occurrence. Increased risks were also noted for inguinal hernia, hypospadias, Down's syndrome, cleft lip or palate (or both), clubfoot, and congenital heart disease, for which the standardized morbidity ratios were 3.6, 4.7, 17.8, 11.3, 11.7, and 2.7, respectively. The increased risk for malignant neoplasms observed in this cohort of patients with cryptorchidism is consistent with that found in earlier studies.

Abnormalities, Multiple↗

Psychologic and adaptational difficulties anteceding amyotrophic lateral sclerosis: Rochester, Minnesota, 1925-1987.

Comprehensive medical records of 45 amyotrophic lateral sclerosis (ALS) patients and 90 controls from the same community, matched by age, gender, and period of observation, were reviewed. Three (13%) of 23 men with ALS, 15 (33%) of 46 control men, 10 (45%) of 22 women with ALS, and 19 (43%) of 44 control women had antecedent psychologic or adaptational difficulties. The proportions of long-standing or serious conditions were comparable in all four groups. However, no man in whom ALS developed had a record of mild antecedent difficulties alone, whereas 3 would have been expected (p = 0.024).

Adaptation, Psychological↗

Incidence and clinical features of glossopharyngeal neuralgia, Rochester, Minnesota, 1945-1984.

The annual crude incidence rate of glossopharyngeal neuralgia per 100,000 population in Rochester, Minn., for 1945 through 1984, was 0.7 for both sexes combined, suggesting that glossopharyngeal neuralgia is a rare disease. There were no significant differences between the sexes (p greater than 0.10) in the overall age-adjusted (to the total 1980 US population) rates: 1.1 for men and 0.5 for women. Overall age-specific crude rates increased slightly with age. Our results and conclusions, achieved by comparing our data with a large referral study at Mayo Clinic, suggest that glossopharyngeal neuralgia is generally a mild disease, since mild attacks are not uncommon, the average annual recurrence rate for a second episode is low (3.6%), and only one fourth of the cases had to have surgery for relief of symptoms. Bilaterality is not uncommon; it was observed in one fourth of the patients, all of whom had mild disease.

Adult↗

Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: similarities and differences, Rochester, Minnesota, 1945-1984.

A comparison of epidemiological and clinical features of trigeminal neuralgia (TN) and glossopharyngeal neuralgia (GN) in Rochester, Minn., reveals several differences. The overall age- and sex-adjusted annual incidence rates were significantly higher for TN than for GN (4.7 vs. 0.8 per 100,000 population). The TN:GN ratio was increased for both men and women and was 5.9:1 for both sexes combined. This ratio is greater than reported in previous non-population-based studies. GN is a milder disease than TN, as indicated by the number of episodes, treatment, and characterization of pain. The right side is affected more often with TN than with GN. Bilaterality was noted less often in TN than in GN cases.

Adult↗

A population-based study of migraine headaches in Olmsted County, Minnesota. Case ascertainment and classification.

Using the unique resources of the Rochester Epidemiology Project for population-based studies, we identified 629 Olmsted County, Minn., residents who fulfilled the 1988 International Headache Society criteria for newly diagnosed migraine over a 3-year period. Over 6,400 patient records from several diagnostic rubrics were screened; a substantial proportion of cases had been 'signed-out' to diagnoses other than 'migraine headache'. Medical records were reviewed by two trained nurses who abstracted supporting data for two neurologists. The neurologists determined whether each case met eligibility requirements and assigned a headache diagnosis by consensus. The diagnostic criteria offered some flexibility and were adapted to retrospective record-based research. Most records contained enough information to effectively classify the headache, although information on the frequency and duration of attacks proved to be problematic. A validation re-abstraction of a 10% sample of cases was undertaken with acceptable reproducibility of symptoms and diagnosis. Our study shows that migraine headache can be studied retrospectively through existing detailed medical records.

Headache↗

50-year trends in the incidence of anorexia nervosa in Rochester, Minn.: a population-based study.

OBJECTIVE: The aim of the study was to determine incidence and prevalence rates and long-term trends in incidence of anorexia nervosa by identifying all persons residing in the community of Rochester, Minn., during the 50-year period 1935 through 1984 who had the disorder. METHOD: From a community-based epidemiologic resource, 13,559 medical records with diagnoses of amenorrhea, starvation, weight loss, anorexia nervosa, or other conditions were screened to identify true cases of anorexia nervosa determined by using standard diagnostic criteria. RESULTS: One hundred eighty-one residents (166 female and 15 male) fulfilled the diagnostic criteria for anorexia nervosa; these were the incidence cases. Due to a quadratic trend in the rates for girls 10-19 years old, the incidence rate among female residents fell from 16.6 per 100,000 person-years in the 1935-1939 period to a low of 7.0 in 1950-1954 and increased to 26.3 in 1980-1984. The incidence rates for women 20 years old and older and for males remained constant. For females 15-24 years old, there was a linear increase. The overall age-adjusted incidence rate per 100,000 person-years was 14.6 for females and 1.8 for males. The prevalence rate per 100,000 population was 269.9 for females and 22.5 for males. CONCLUSIONS: Anorexia nervosa is more common than previously recognized. Among girls 15-19 years old it is a very common chronic illness. Its incidence has increased among females 15-24 years old but not among older women or among males.

Adolescent↗

The association between Alzheimer's disease and thyroid disease in Rochester, Minnesota.

To determine whether an association exists between Alzheimer's disease (AD) and thyroid disease, we carried out two studies in the population of Rochester, Minnesota. We reviewed medical records of a cohort of 198 women with histologically confirmed Hashimoto's thyroiditis (1935 to 1974) for evidence of subsequent dementia, applying the criteria used for dementia in a previous determination of incidence and prevalence rates in this population. From a total of 4,197 person-years of follow-up, eight cases of AD were diagnosed, whereas the expected number was 5.8. The standardized morbidity ratio was 1.37, which failed to reach statistical significance. The second study was a retrospective case-control comparison that sought any relationship between AD and all thyroid disorders, using a previously identified (1960 to 1979) AD cohort (N = 646) and their age- and sex-matched controls. For myxedema there was a positive association for AD without significance, whereas in Graves' disease there was a significant negative association for AD.

Adolescent↗

Is the prevalence of dementia changing?

We compared the point prevalence rates of dementing illnesses in the population of Rochester, Minnesota, on January 1, 1980, with the previously published rates of January 1, 1975, by using extensive health care records available from all sources of care in the community, in order to identify and classify cases with standard diagnostic criteria derived from DSM-III. The overall age- and sex-adjusted prevalence rate per 100,000 population for dementia on January 1, 1980, was 402.5 compared with 388.4 on January 1, 1975; for Alzheimer's disease it was 259.8 in 1980 and 259.5 in 1975. The stability of the rates suggests no change in the incidence and mortality associated with these conditions. The prevalence rates for Rochester, Minnesota, are similar to many other rates estimated in other North American communities, but they differ from two other population-based estimates from East Boston and California. Case definitions and methods of assessment probably account for the differences in estimated prevalence.

Adult↗

Clinical risk factors for Alzheimer's disease: a population-based case-control study.

Using information on clinical risk factors provided through the medical record linkage system of the Rochester Epidemiology Project, we conducted a population-based case-control study of Alzheimer's disease (AD). During the period 1960 to 1974, we identified 415 newly diagnosed cases of AD among residents of Rochester, Minnesota, and matched one community control to each case based on age, sex, and duration of community medical record. We estimated odds ratios using conditional logistic regression for several potential clinical risk factors of AD. Among more than 20 clinical risk factors that were evaluated, the only statistically significant findings were for episodic depression, personality disorder, and hypertension.

Alzheimer Disease↗

Incidence of psoriasis in Rochester, Minn, 1980-1983.

This population-based study was carried out using the medical records linkage data resource for the population of Rochester, Minn, at Mayo Clinic. There were 132 newly diagnosed cases of psoriasis identified during a 4-year period (1980 through 1983); 88% of the cases had been seen and diagnosed by a dermatologist. The overall crude incidence rate was 57.6 per 100,000 population; for men and women, the rates were 54.4 and 60.2, respectively. The overall sex- and age-adjusted (1980 US white population) incidence rate was 60.4 per 100,000 person-years. The highest rate of occurrence (112.6) was in the 60- to 69-year-old age group. Most of the cases of psoriasis diagnosed in this study (58%) were mild, and the patients had psoriatic lesions on less than 10% of their body. There are no other published incidence rates for this condition with which to make comparisons.

Adult↗

Incidence and clinical features of trigeminal neuralgia, Rochester, Minnesota, 1945-1984.

The overall crude incidence rate of trigeminal neuralgia per 100,000 population in Rochester, Minnesota, for 1945 through 1984 was 4.3 for both sexes combined. The age-adjusted (to total 1980 US population) rate for women (5.9) was significantly higher than that for men (3.4). Annual incidence rates increased significantly with age in both women and men. Data based on evidence in the medical records suggest that trigeminal neuralgia is a rather rare and unpredictable disease: The number of episodes varies from 1 to 11, and length of episode from 1 day to 4 years. This study indicates an elevated relative risk associated with hypertension (both overall and among women in the cohort). Also, prevalence of multiple sclerosis was significantly greater among the group of 75 patients who had trigeminal neuralgia. Since the data on treatment in this study do not correspond to a randomized clinical trial, they are presented as empirical results only and show no single treatment of choice for trigeminal neuralgia.

Adult↗

Ascertainment of risk factors for osteoporosis: comparison of interview data with medical record review.

To determine the accuracy of self-reported risk factors for osteoporosis, an age-stratified random sample of Rochester, MN, women was studied. Results from a structured face-to-face interview were compared with information documented in contemporary inpatient and outpatient health care records in the community. Using the kappa statistic to evaluate concordance of these two data sources, we found substantial agreement for a history of proximal femoral and distal forearm fractures, peptic ulcer disease, estrogen replacement therapy and oral contraceptive use, and cigarette and alcohol exposure. Moderate agreement was seen for histories of other age-related fractures, hysterectomy or oophorectomy, thyroidectomy, and use of thyroid supplements. Poor agreement was found for prior thyroid disease, gastrectomy, and corticosteroid or anticonvulsant use. This study demonstrates a need for greater attention to the quality of self-reported risk factor data in studies of bone loss and fractures.

Adult↗

Cutaneous malignant melanoma in Rochester, Minnesota: trends in incidence and survivorship, 1950 through 1985.

In Rochester, Minnesota, 107 incidence cases of cutaneous malignant melanoma (in 46 male and 61 female patients) were diagnosed during the years 1950 through 1985. Overall crude incidence rates were 6.0 and 6.6 per 100,000 males and females, respectively. Evaluation of trends in 9-year periods showed that the rates increased from 3.2 to 8.9 for males (P = 0.015) and from 4.4 to 11.7 for females (P less than 0.001). Age-specific rates suggested that the highest incidence occurs in the age-groups 50 to 59 years and 70 years or older for males and 40 to 49 years and 70 years or older for females. Lesions were most common in the head and neck area among males (P = 0.044) and on the lower extremities among females (P = 0.018). The most frequent histologic type was superficial spreading melanoma (61%). Five-year survival was diminished overall for patients with cutaneous malignant melanoma--0.72 in comparison with 0.88 expected for the general population. Statistically significant risk factors for survival were depth of invasion of the lesion (Clark level), thickness of the lesion, histologic type, and age of the patient.

Adult↗

Incidence of lumbar disc surgery. A population-based study in Olmsted County, Minnesota, 1950-1979.

Age- and sex-specific incidence rates of operation for suspected lumbar disc prolapse were determined for residents of Olmsted County, Minnesota, for the 30-year period 1950 through 1979. The incidence rate (adjusted to the age and sex distribution of the United States white population in 1980) was 52.3 per 100,000 person-years for all such operations and 46.3 per 100,000 person-years for initial operations. These rates remained fairly constant over the study period. A distinction was made between surgically proven and unproven cases of lumbar disc prolapse. Patients with a surgically proven lumbar disc prolapse had about 10 times the risk of another operation for disc prolapse within 10 years after the first operation compared with the general population.

Adolescent↗

Case-control study of neuroepithelial tumors in Rochester, Minnesota, 1950-1977.

Rochester, Minnesota, has over many decades the highest reported incidence rates of primary intracranial neoplasms. This occurs in the absence of any readily identifiable risk factors. A case-control study of neuroepithelial tumors has been undertaken utilizing the records-linkage system at the Mayo Clinic. This study failed to yield any significant findings for the factors examined.

Adenoma↗

Alzheimer's disease and prior therapeutic radiation exposure: a case-control study.

Few risk factors have been identified for dementing illness to date. To evaluate prior therapeutic radiation exposure as a potential risk factor for Alzheimer's disease, we carried out a retrospective case-control study using the Rochester Epidemiology Resource. Cases were all incident cases of AD from 1960 through 1974 (N = 392) identified in an ongoing study of the condition in this community. One age- and sex-matched control for each case was selected from all registrations for care during the year of onset in the case. There were 86 cases and 89 controls with prior radiation exposure, and the variable used to describe exposure was absorbed dose. Most of the exposure was small doses: 11 individuals received greater than 1,000 centigray (3 cases, 8 controls). Using the logistic regression methods of Breslow and Day, the estimated odds ratio for any prior therapeutic radiation exposure was 0.95 (95% CI, 0.66 to 1.37). When the exposure variable was limited to head exposure only, the odds ratio was 0.65 (95% CI, 0.32 to 1.31). It is unlikely that the risk associated with therapeutic radiation in the development of Alzheimer's disease is greater than 1.4.

Aged↗

An anatomy of the autopsy, Olmsted County, 1935 through 1985.

In this study, we examined in detail the patterns of autopsy rates for a half century (1935 through 1985) among residents of Olmsted County, Minnesota. The time trend of the autopsy in this community represents, in many respects, a microcosm of national trends. In the process of this analysis, we identified several medical and socioeconomic variables that may influence the rate of autopsy, including the age at death, physical location of death, gender, surgical procedures preceding death, immediate cause of death, and direct and indirect costs of the autopsy. In particular, the advancing mean age at death and the increase of the nursing home as a social phenomenon seem to have had a profound effect on autopsy rates both in Olmsted County and throughout the United States.

Adult↗