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Biomedical subjects

D E Lilienfeld

Publications and source records attributed to D E Lilienfeld.

At least 19 recordsLinked to original sources
PubMed1992

Geographic distribution of pulmonary embolism mortality rates in the United States, 1980 to 1984.

The identification of individuals who are at high risk for developing PE has focused on clinically identified groups. Epidemiologic characterization of high-risk populations has been less successful. To provide a demographic basis for further epidemiologic inquiry into groups at high risk for PE, we investigated the geographic distribution of PE mortality rates in the United States from 1980 to 1984. We found that for most sections of the United States, PE mortality rate patterns mirrored those that were observed previously for the nation. Men had greater PE mortality rates than women in most regions, and nonwhites had greater PE mortality rates than did whites. The exception to this pattern was the Pacific region, where the PE mortality rate was lower than rates in other parts of the country, particularly among nonwhites. This pattern probably reflects the different racial compositions in the regional populations of the United States, with corresponding PE risk factor differences. However, the specific risk factors that are responsible for these patterns have not been identified. Further inquiry into these geographic patterns may provide a means for the prevention of high PE morbidity and mortality rates.

Adult↗
PubMed1992

Morbidity from congestive and hypertrophic cardiomyopathy in the Minneapolis-St. Paul metropolitan area: 1979-1984.

In order to develop an epidemiologic profile of congestive and hypertrophic cardiomyopathy, we reviewed hospital discharge diagnosis data for the Minneapolis-St. Paul metropolitan area from 1979 to 1984. For congestive cardiomyopathy, we found statistically significant increases in the age-adjusted hospital discharge diagnosis rate for both men (from 63 to 125/100,000 population/year) and women (from 35 to 58/100,000 population/year). We also found that the age-specific rates increased significantly among older men (55-64 years of age, from 86 to 198/100,000 population/year; 65-74 years of age, from 182 to 322/100,000 population/year) and older women (65-74 years of age, from 106 to 196/100,000 population/year). The rates increased with advancing age for both genders. Men had greater rates than women. For hypertrophic cardiomyopathy, no temporal trends could be discerned. Women were observed to have greater age-specific rates than men; the age-adjusted rates were, however, approximately the same for men and women. The hospital discharge diagnosis rate increased with advancing age among both men and women. The possible reasons for these observed patterns, including the major impact of improvements in diagnosis during the observation period, are discussed. Additional research into these disorders is needed.

Adult↗
PubMed1992

Childhood asthma and passive smoking. Urinary cotinine as a biomarker of exposure.

To assess the relationship between passive smoking and asthma, we investigated (1) whether passive smoking was more prevalent among asthmatic than control children and (2) whether exposure to tobacco smoke was higher in acute asthma than in nonacute asthma. Three groups were recruited into a case-control study: 72 acute asthmatic children from the emergency room (ER), 35 nonacute asthmatic children from the asthma clinic, and 121 control children from the ER. Both questionnaire and urinary cotinine/creatinine ratio (CCR) were used to assess passive smoking. Levels of CCR greater than or equal to 30 ng/mg were used to identify children exposed at home. Mean CCR was also computed. Acute and nonacute asthmatic children had similar prevalences of passive smoking at home. Acute cases showed a higher mean CCR than nonacute cases, but this was not significant. In comparing all asthmatic to control children, smoking by the maternal caregiver was more prevalent among asthmatic children (odds ratio OR = 2.0, 95% CI 1.1, 3.4). This was confirmed by CCR greater than or equal to 30 ng/mg (OR = 1.9, 95% CI 1.04, 3.35) and by the difference in mean CCR (43.6 versus 25.8 ng/mg, p = 0.06). We conclude that smoking by the maternal caregiver is associated with clinically significant asthma in children. We could not show that it is a trigger of acute asthma attacks.

Acute Disease↗
PubMed1991

Asbestos-associated pleural mesothelioma in school teachers: a discussion of four cases.

The causal relationship between malignant mesothelioma and exposure to asbestos is well established. In part as a result of that association, much public attention has focused on asbestos abatement in buildings, such as public schools, in which that asbestos was used as a construction material. The present communication is a report of four cases of malignant mesothelioma in school teachers whose only apparent exposure to asbestos was in the schools in which they taught. The concerns raised by this report are also discussed.

Adult↗
PubMed1991

Parkinson's and motoneuron disease morbidity in the Twin Cities metropolitan area: 1979-1984.

To better characterize the morbidity from Parkinson's disease and motoneuron disease, we examined hospital discharge diagnosis data for all acute care facilities (except for the Veterans Administration Medical Center) in the Minneapolis-St. Paul area in each year from 1979 to 1984 for persons aged 30-74 years. For each person in whom the discharge diagnosis included either Parkinson's disease or motoneuron disease, the age, gender, and year of admission were recorded. Annual age-gender-specific and age-adjusted gender-specific hospital discharge diagnosis rates were calculated. For Parkinson's disease, for both, men and women, the age-adjusted hospital discharge diagnosis rate declined by 26-27%. Component age-specific data for Parkinson's disease showed more variable temporal changes. For motoneuron disease, no temporal changes were observed, although the number of observations was small. These data suggest that Parkinson's disease is declining in prevalence in the hospitalized population. The implications for motoneuron disease are less clear. Further studies in this area are needed.

Adult↗
PubMed1991

The silence: the asbestos industry and early occupational cancer research--a case study.

To gain insight into corporate activities regarding the identification of occupational carcinogens earlier in this century, the actions of one industry, the asbestos industry, were reviewed. This industry, in concert with many of its insurers, systematically developed and then suppressed information on the carcinogenicity of asbestos. The development of warnings for those exposed to the asbestos was delayed. As a result, millions of workers were exposed to the carcinogen and hundreds of thousands died. These events are placed into the context of similar activities in other industries during this time.

Asbestos↗
PubMed1990

Trends in pulmonary embolism death rates for Canada and the United States, 1962-87.

To investigate the effect of advances in the prevention and treatment of pulmonary embolism, we examined the rates of death from pulmonary embolism in Canada for 1965-87 and compared them with those for the United States for 1962-84. The direct method of age standardization was used on sex-specific and age-specific death rates, with the 1960 US population as the standard. In both countries the death rates increased then decreased, although the changes in the Canadian rates occurred later and were less pronounced than those in the US rates. Men and elderly people were at higher risk of death from pulmonary embolism than women and younger people. Prevention strategies, possibly including encouraging a more active lifestyle and targetting high-risk groups, may further reduce pulmonary embolism death rates in both countries.

Adolescent↗
PubMed1990

Two decades of increasing mortality from Parkinson's disease among the US elderly.

To examine the possible role of environmental factors in the cause of Parkinson's disease (PD), we reviewed mortality trends for PD in the United States from 1962 through 1984. We found that age-specific mortality for PD in all demographic groups had changed notably during this 23-year interval. Among whites of both sexes, substantial declines were observed among the middle-aged, while notable increases were seen in the geriatric age groups. Similar changes were found in nonwhites; among nonwhites in the geriatric age range, increases of 22% to 553% were observed among women. Men generally had a 100% higher risk of death due to PD than did women. Whites were at three times the risk of nonwhites. The observed temporal changes appear to reflect improved treatment, better case ascertainment, and a true rise in the incidence of PD, particularly among the elderly. This rise may be due to preventable environmental causes and will require further investigation.

Aged↗
PubMed1990

Hospitalization and case fatality for pulmonary embolism in the twin cities: 1979-1984.

To better characterize the morbidity from pulmonary embolism, we examined hospital discharge data for all acute care facilities (except for the Veterans Administration Medical Center) in the Minneapolis-St. Paul metropolitan area in each year from 1979 to 1984 for persons aged 30 to 74 years. For each person in whom the discharge diagnoses included pulmonary embolism, the age, sex, year of admission, and vital status at discharge were recorded. Annual age-sex-specific and age-adjusted sex-specific hospitalization rates were calculated. Similar analyses were undertaken for case fatality. With the exception of men younger than 55 years of age, all groups experienced significant decline in the pulmonary embolism discharge rate. No significant temporal changes were observed in any of the case fatality rates. These data suggest that changes in pulmonary embolism mortality in the United States from 1979 to 1984 may reflect declining occurrence of the disease and are likely not the result of changes in case fatality. Further studies in this area are needed.

Age Factors↗
PubMed1990

Parkinsonism death rates by race, sex and geography: a 1980s update.

To evaluate temporal changes in the geographic distribution of Parkinson's disease (PD) mortality in the United States, we reviewed death rates for PD in the nine regions of the United States for 1980-1984. Age-adjusted mortality for all ages and for the elderly (65 years of age and older) was analyzed. Variation in PD mortality was observed among the regions for all demographic groups. The patterns were different from those reported during 1959-1961. Changing geographic patterns in mortality provide evidence for an environmental etiology for PD.

Cause of Death↗
PubMed1990

Mortality from pulmonary embolism in the United States: 1962 to 1984.

To examine the effect of advances in the prevention of and therapy for PE, we reviewed mortality for PE in the United States from 1962 to 1984. Age-adjusted PE mortality increased by 67 to 100 percent between 1962 and 1974 for white and non-white men and women. From 1975 to 1984, these rates declined by 20 to 28 percent. Non-white PE mortality was greater than white PE mortality; men had a greater risk of PE death than women. Age-specific patterns (more than 40 years of age) of PE mortality followed those of the age-adjusted death rates, with increases noted in all groups between 1962 and 1974 and declines during the 1975-1984 period. These patterns might reflect improved ascertainment of cases and better prevention of disease. The magnitude of the rates suggests that the list of indications for prophylactic anticoagulation should be re-examined for possible expansion.

Adult↗
PubMed1989

Rising mortality from motoneuron disease in the USA, 1962-84.

From 1962 to 1984, age-specific mortality for motoneuron disease (MND) in the United States rose in all demographic groups over the age of 40. The increase was seen in both men and women, and both whites and non-whites, and was most pronounced in the elderly (eg, 378% in white women aged 80-84 years). Men were at 50% higher risk than women, and whites had twice the risk of non-whites. These increases may reflect an improvement in case ascertainment, but they also seem to show a true rise in the incidence of MND, particularly among the elderly. Such an increase suggests an environmental aetiology.

Adult↗
PubMed1979

Gastric cancer etiology: a biochemical hypothesis.

We have proposed a two-stage biochemical model for the etiology of "intestinal" gastric cancer. The model postulates that the gastric mucosal barrier is biochemically pierced as a result of chemical interactions between the mucoproteins and mucopolysaccharides of the barrier and ingested polysaccharrides (starches). This would allow the growth of gastric flora which could produce carcinogenic nitrosamines and/or nitrosamides. Observational and experimental evidence in favor of the model is provided. The model suggests various research initiatives, the results of which might provide the basis for biochemical and physiological methods for the prevention and/or treatment of gastric cancer. Various ways in which the model may be tested are also noted.

Adult↗