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Biomedical subjects

D J Gordon

Publications and source records attributed to D J Gordon.

At least 73 records · Page 4Linked to original sources
PubMed1988

Cyclic seasonal variation in plasma lipid and lipoprotein levels: the Lipid Research Clinics Coronary Primary Prevention Trial Placebo Group.

Seasonal plasma lipid and lipoprotein cycles were studied in 1446 hypercholesterolemic 35-59 year-old men followed for 7 years as the placebo group of the Lipid Research Clinics (LRC) Coronary Primary Prevention Trial (CPPT). Separate periodic time series were calculated for each study participant; mean parameter estimates were obtained by vector algebra. Highly significant (p less than 0.001) synchronous sinusoidal seasonal cycles, peaking in the first month of winter, were demonstrated for plasma levels of total (TOT-C), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) cholesterol. Their mean seasonal changes (nadir to zenith) were 7.4, 6.4, and 0.8 mg/dl, respectively. An irregular but statistically significant seasonal pattern was also observed for plasma triglyceride (TG) levels, with peak levels in the autumn. The variation of these seasonal effects among subgroups and geographic locales and their correlation with seasonal weight and dietary patterns yielded few clues as to their underlying etiologic mechanisms.

Adult↗
PubMed1988

Laboratory animal allergy in a pharmaceutical company.

A cross sectional survey was carried out on 138 workers exposed to laboratory animals. Sixty (44%) had symptoms in a self completed questionnaire that were consistent with laboratory animal allergy (LAA) of whom 15 (11%) had chest symptoms. There was a positive skin prick test to one or more animal urine extracts (rat, mouse, guinea pig, rabbit) in 13% and 38% had a positive radioallergosorbent test to urine extract. LAA chest symptoms were almost five times more common in atopic than non-atopic subjects (who were distinguished by skin test response to common, non-animal aeroallergens). A positive skin test to animal urine was associated with LAA chest symptoms and with atopy. Nose, eye, or skin symptoms without chest symptoms were not associated with atopy. There was an inverse relation between duration of employment at the firm and LAA chest symptoms, suggesting selection of affected people out of employment with animals.

Adult↗
PubMed1988

Physical activity and coronary heart disease among asymptomatic hypercholesterolemic men (the Lipid Research Clinics Coronary Primary Prevention Trial).

We examined the relation between reported regular strenuous exercise or hard physical labor and the incidence of coronary heart disease (CHD) death and nonfatal myocardial infarction among 1,533 hypercholesterolemic men aged 35-59 years who were in the placebo group of the Lipid Research Clinics Coronary Primary Prevention Trial. The mean follow-up of the cohort was 7.4 years. The men were free of clinical heart disease at entry; men with an abnormal resting electrocardiogram or graded exercise test also were excluded. Regular physical activity was not associated with the incidence of CHD (RR = .94, 95% CI = .68, 1.38) in this study population. Adjustment by the proportional hazards model for age, low-density lipoprotein cholesterol, smoking, family history of CHD, and occupation did not alter this finding. This observation suggests that reported regular physical activity may not be related to the risk of coronary heart disease among asymptomatic, hypercholesterolemic, middle-aged men.

Adult↗
PubMed1988

Occupational allergy to locusts: an investigation of the sources of the allergen.

Allergic symptoms occur commonly in subjects working closely with locusts and are associated with specific IgE antibody. Extracts of intact locusts (Schistocerca gregaria and Locusta migratoria) were used to identify specific IgE antibody, to define the major allergens of the locust and their sources, and to estimate aeroallergen concentration in the working environment. With questionnaire, skin prick tests, and specific IgE measurements, 35 individuals, working in a research center, were surveyed. Of the 15 currently exposed individuals, contact with locusts provoked asthma, rhinitis, and contact urticaria in five, rhinitis and urticaria in three, and rhinitis alone in one individual. Symptoms provoked by locusts and skin test reactions to locust extracts were associated with specific IgE antibody in the serum. The "immunoblot" technique demonstrated the presence of multiple allergens in the locust extracts of approximately 68, 66, 54, 43, 37, 29, and 18 K daltons molecular weight. Locust antigen was identified in the atmosphere by means of an immunochemical method involving elution of high-volume air-sampler filters exposed in the locust breeding room and analysis of eluate allergen content by RAST-inhibition assays. Logit transformation of RAST-inhibition lines demonstrated that the filter extract shared a common slope with the locust extract and with an extract of locust gut. This gut extract also shared a common slope with extracts of locust feces and peritrophic membrane. The major source of allergen appears to be the peritrophic membrane that is present in the gut and is excreted surrounding the feces.

Allergens↗
PubMed1987

Change in physician perspective on cholesterol and heart disease. Results from two national surveys.

The National Heart, Lung, and Blood Institute sponsored national telephone surveys of practicing physicians in 1983 (N = 1610) and 1986 (N = 1277) to assess attitudes and practices regarding elevated serum cholesterol levels. The 1983 survey was conducted just before the release of the results of the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease. In 1986, 64% of physicians thought that reducing high blood cholesterol levels would have a large effect on heart disease, up considerably from 39% in 1983. Whereas in 1983, physicians attributed considerably less preventive value to reducing the cholesterol level than to reducing blood pressure or smoking, this disparity was substantially smaller in 1986. The median range of blood cholesterol at which diet therapy was initiated was 6.21 to 6.70 mmol/L (240 to 259 mg/dL) in 1986, down from 6.72 to 7.21 mmol/L (260 to 279 mg/dL) in 1983; the median for drug therapy was 7.76 to 8.25 mmol/L. (300 to 319 mg/dL) in 1986 and 8.79 to 9.28 mmol/L (340 to 359 mg/dL) in 1983. In 1986, 87% of physicians surveyed felt that medical evidence warranted the recommended treatment levels set forth in the 1984 National Institutes of Health Consensus Conference on Lowering Blood Cholesterol. These changes indicate that by 1986, physicians were more convinced of the benefit of lowering high blood cholesterol levels and were treating patients accordingly. The data also suggest areas for continued educational initiatives.

Adult↗
PubMed1987

Change in public perspective on cholesterol and heart disease. Results from two national surveys.

The National Heart, Lung and Blood Institute, Bethesda, Md, and the Food and Drug Administration, Washington, DC, sponsored two national probability telephone surveys (N = 4000) of adults to assess attitudes and knowledge about heart disease risk from high blood cholesterol levels and the public's efforts to lower blood cholesterol levels. The first survey was conducted in 1983, before release of the results from the Lipid Research Clinics Coronary Primary Prevention Trial, which showed that a reduction in the blood cholesterol level reduced coronary heart disease; the second survey was conducted in 1986. The percentage of adults who believed that reducing high blood cholesterol levels would have a large effect on heart disease increased from 64% in 1983 to 72% in 1986, so that the importance attached to reducing high blood cholesterol levels approached that attributed to reducing smoking and high blood pressure. In 1983, 35% of adults reported that they had their cholesterol level checked vs 46% in 1986. In both years, diet changes were most frequently chosen (greater than 60%) as ways to control the blood cholesterol level; reducing dietary fat was believed to be as important as reducing dietary cholesterol. By 1986, 23% of adults reported that they made dietary changes specifically to lower their blood cholesterol level, up from 14% in 1983. These comparative data show gains in public awareness and action relating to high blood cholesterol level risk. The data can be used to develop education programs.

Attitude to Health↗
PubMed1987

Respiratory allergy to inhaled bat guano.

In the Sudan many asthmatic patients attribute their symptoms to inhalation of bat droppings. Design of the roofs of many Sudanese buildings allows black bats to roost; guano drops through cracks in the ceiling into the rooms below where it can be inhaled and cause allergic respiratory disorders. Seven atopic patients seen at Sennar Hospital with bat-related case-histories were investigated. Six had bronchial asthma and allergic rhinitis and one had asthma alone. Extracts of yellow hairy bat, black bat, and bat droppings were made. All seven patients had a positive skin prick test and specific IgE antibodies (RAST) to bat droppings. Three patients also had a positive RAST to both yellow and black bats and one patient to yellow bat. Droppings are probably the major allergen source in bat-related respiratory allergy.

Adult↗
PubMed1987

Cross-reactivity between antigens of fungal extracts studied by RAST inhibition and immunoblot technique.

We have used the RAST-inhibition technique in homologous and heterologous inhibitions of the Aspergillus fumigatus, Alternaria tenuis, and Cladosporium herbarum RAST assays followed by the immunoblot technique to assess the degree of shared allergenic determinants in these extracts. In the Aspergillus RAST, there was little or no inhibition with Cladosporium and Alternaria, but considerable cross-reactivity was found between Alternaria and Cladosporium. Inhibition by Alternaria of the Cladosporium RAST was found in a dose-dependent fashion in one serum, whereas all four sera in the Alternaria RAST were inhibited by Cladosporium in this fashion. Logit transformation of the Alternaria RAST-inhibition curves produced common slopes with Alternaria and Cladosporium in three of the four sera, indicating their immunologic identity. The immunoblot technique confirmed the degree of cross-reactivity found by RAST inhibition among the molds. This evidence of common allergenic determinants in these fungi could help to explain the observation that mold-allergic patients often have skin test reactions to several fungi.

Alternaria↗
PubMed1987

Smoking, physical activity, and other predictors of endurance and heart rate response to exercise in asymptomatic hypercholesterolemic men. The Lipid Research Clinics Coronary Primary Prevention Trial.

The association of known coronary risk factors with progressive submaximal treadmill exercise tolerance test performance was studied in 6,238 asymptomatic white 34-60-year-old hypercholesterolemic men screened between 1973 and 1976 for the Lipid Research Clinics Coronary Primary Prevention Trial. Cigarette smoking and habitual physical inactivity were each associated with a doubling of the rate of symptom-related discontinuation of the exercise test; the tests of sedentary smokers were discontinued at four times the rate observed for active nonsmokers. Smaller increases in heart rate were observed during exercise testing in physically active men and in smokers than in their sedentary and nonsmoking counterparts. Thus, smoking, like habitual physical activity, reduced the heart rate required to sustain a given external workload. However, the heart rates of smokers tended to remain elevated after exercise, while those of physically active men returned more rapidly toward resting levels. Age, Quetelet index, and low plasma levels of high density lipoprotein cholesterol were also strong predictors of decreased endurance, while resting heart rate and blood pressure levels were significant predictors of heart rate response. Comparison of these results with those previously reported for ischemic electrocardiographic changes in this cohort suggests that coronary risk factors may selectively influence specific aspects of exercise tolerance test performance.

Adult↗
PubMed1987

Seasonal cholesterol cycles: the Lipid Research Clinics Coronary Primary Prevention Trial placebo group.

Seasonal variation of plasma cholesterol levels was studied in 1446 hypercholesterolemic 35- to 59-year-old male participants in the Lipid Research Clinics Coronary Primary Prevention Trial placebo group. Each man's serial cholesterol data, obtained at bimonthly intervals for 2.0 to 6.5 years, were analyzed as a separate periodic time series, and distributions of cycle zeniths and amplitudes were calculated. A highly significant (chi 2= 706, 2 degrees of freedom) seasonal effect, 7.4 mg/dl higher on December 30 than on June 30, was found. This effect was similar among the 12 LRC centers, including such disparate climates as those of Minneapolis and San Diego, and tended to be larger in the southern centers. Its magnitude was independent of baseline levels of plasma cholesterol and other baseline characteristics. Observed seasonal differences in weight and diet explained less than one-third of the seasonal variation in plasma cholesterol levels. Plasma low- and high-density lipoprotein cholesterol levels, analyzed similarly, also showed significant synchronous seasonal cycles. Plasma triglyceride levels showed a weaker irregular seasonal pattern, highest in midsummer and late autumn and lowest in spring. The etiologies and mechanisms for these seasonal patterns remain largely unknown.

Adult↗
PubMed1986

Dietary and other correlates of changes in total and low density lipoprotein cholesterol in hypercholesterolemic men: the lipid research clinics coronary primary prevention trial.

Correlates of changes in total (TOTAL-C) and low density lipoprotein cholesterol (LDL-C) were examined in the 3806 hypercholesterolemic men of the Lipid Research Clinics Coronary Primary Prevention Trial. These correlates included changes in weight, dietary and alcohol intake, plasma glucose and thyroxine, cigarette smoking, packet count, lipid-lowering drugs other than cholestyramine, and antihypertensive drugs. In both placebo plus diet and cholestyramine plus diet treatment groups, decreases in Quetelet index and in saturated fat and cholesterol intake and increases in polyunsaturated fat intake were consistently associated with reductions in TOTAL-C and in LDL-C. In the cholestyramine group, plasma glucose and smoking were predictors of increased TOTAL-C and LDL-C; age and packet count were predictors of decreased TOTAL-C and LDL-C. Diuretic use was associated with increases in TOTAL-C in both groups and with increases in LDL-C in the cholestyramine group.

Adult↗
PubMed1986

Predictive value of the exercise tolerance test for mortality in North American men: the Lipid Research Clinics Mortality Follow-up Study.

More than 3600 white men, from 30 to 79 years old and without a history of myocardial infarction, underwent submaximal treadmill exercise tolerance tests as part of their baseline evaluation for the Lipid Research Clinics Mortality Follow-up Study. The exercise test was conducted according to a common protocol and coded centrally; depression of the ST segment by at least 1 mm (visual coding) and/or 10 microV-sec (ST integral, computer coding) signified a positive test. Concurrent measurements of age, blood pressure, history of cigarette smoking, and plasma levels of lipids, lipoproteins, and glucose, as well as other coronary risk factors, were obtained. Cumulative mortality from cardiovascular disease was 11.9% (22/185) over 8.1 years mean follow-up among men with a positive exercise test vs 1.2% (36/2993) over 8.6 years mean follow-up among men with a negative test. Three-quarters (43) of these deaths were due to coronary heart disease. The relative risk for cardiovascular mortality associated with a positive exercise test was 9.3 before and 4.6 after age adjustment. Cardiovascular mortality rates were especially elevated (relative risk 15.6 before and 5.1 after age adjustment) among the 82 men whose exercise tests were adjusted "strongly" positive based on degree and timing of the ischemic electrocardiographic response. A positive exercise test was also moderately associated with noncardiovascular mortality; the relative risk for all-cause mortality was 7.2 before and 3.4 after age adjustment. The relative risk for cardiovascular mortality associated with a positive exercise test was not appreciably altered by covariance adjustment for known coronary risk factors other than age. A positive exercise test was a stronger predictor of cardiovascular death than were high plasma levels of low-density lipoprotein cholesterol, low plasma levels of high-density lipoprotein cholesterol, smoking, hyperglycemia, or hypertension. Its impact on risk of cardiovascular death was equivalent to that of a 17.4 year increment in age.

Adult↗
PubMed1986

High-density lipoprotein cholesterol and coronary heart disease in hypercholesterolemic men: the Lipid Research Clinics Coronary Primary Prevention Trial.

Plasma levels of high-density lipoprotein cholesterol (HDL-C) at entry and subsequent changes from these baseline levels were inversely predictive of coronary heart disease (CHD) end points in hypercholesterolemic men followed for 7 to 10 years in the Lipid Research Clinics Coronary Primary Prevention Trial, especially in the 1907 participants receiving cholestyramine. When the men in this cohort were compared, each 1 mg/dl increment in baseline HDL-C (mean 44.3 mg/dl) was associated with a 5.5% decrement in risk of "definite" CHD death or myocardial infarction (Z = -5.4), and each 1 mg/dl increase from baseline HDL-C levels (mean increase = 1.6 mg/dl) during the trial was associated with a 4.4% risk reduction (Z = -2.2). In the 1899 participants receiving placebo, the corresponding risk decrements were 3.4% and 1.1%. Although baseline HDL-C level (mean = 44.4 mg/dl) remained a significant risk predictor (Z = -3.8) in the placebo cohort, increases in HDL-C (mean increase 0.5 mg/dl) were not significantly predictive of CHD (Z = -0.6) unless "suspect" as well as "definite" end points were analyzed (Z = -2.0). When the associations between HDL-C (baseline plus change) and incidence of definite CHD end points within each treatment cohort were compared, their difference approached nominal significance (Z = 1.9). The results suggest a synergistic interaction, in which cholestyramine treatment reduced CHD risk most substantially in men maintaining the highest HDL-C levels.

Adult↗
PubMed1985

Occupational allergy to the common house fly. (Musca domestica): use of immunologic response to identify atmospheric allergen.

A 48-year-old scientific worker developed rhinitis that occurred when she entered the housefly (Musca domestica) rearing room where she worked. She was found to have specific IgE antibody to M. domestica in her serum by RAST. She was relocated at work and avoided further occupational exposure to M. domestica. The level of specific IgE decreased in serial samples but subsequently increased after her inadvertent reexposure at work. Extracts of fly-cage dust and of high volume atmospheric samples from the fly-rearing room inhibited the M. domestica RAST in a dose-dependent fashion. After logit transformation the lines of inhibition of the fly cage dust and of the atmospheric samples were parallel and steeper than the self-inhibition by M. domestica, implying the cage dust and atmospheric samples shared antigens not present in the M. domestica extract. This method of monitoring atmospheric antigen has considerable potential for evaluating the effectiveness of environmental change in the workplace.

Air↗
PubMed1984

Coronary risk factors and exercise test performance in asymptomatic hypercholesterolemic men: application of proportional hazards analysis.

The association of established coronary risk factors with submaximal graded treadmill exercise test performance was examined in 6,850 asymptomatic, white 34--59-year-old hypercholesterolemic men screened between 1973 and 1976 at 12 North American Lipid Research Clinics for participation in their Coronary Primary Prevention Trial. The prevalence of ischemic electrocardiographic responses (greater than or equal to 1 mm S-T segment depression) was 8.6%. The Cox proportional hazards method was adapted so as to take into account the level of exercise at which ischemic responses occurred and to which subjects without ischemic responses were exposed. The results were compared with those obtained by standard logistic regression. In both models, age, blood pressure, plasma cholesterol, and (inversely) plasma high-density lipoprotein cholesterol and alcohol consumption were significant independent predictors of an ischemic response to exercise. Surprisingly, ischemic responses were less frequent in smokers than in nonsmokers. However, when the proportional hazards method was used, cigarette smoking was weakly but significantly (p less than 0.01) predictive of an ischemic response on the treadmill. Results from this model differed from those of the logistic model because the former takes into account the reduced exercise capacity of smokers, which renders them less likely to reach workloads sufficient to induce myocardial ischemia. The proportional hazards model similarly demonstrated a possible beneficial effect of habitual physical activity which was not apparent in the logistic model. Quetelet index and plasma triglyceride were only weakly associated with the probability of an ischemic response, and did not contribute significantly to either model.

Adult↗
PubMed1983

Habitual physical activity and high-density lipoprotein cholesterol in men with primary hypercholesterolemia. The Lipid Research Clinics Coronary Primary Prevention Trial.

The association of habitual physical activity with plasma high-density lipoprotein (HDL) cholesterol and total triglyceride (TG) was examined in 7106 asymptomatic 35-59-year-old white men with primary type II hyperlipoproteinemia who attended the second screening visit of the Lipid Research Clinics Coronary Primary Prevention Trial. Subjects were rated by usual level of physical activity at work and outside of work and the frequency of strenuous physical labor or exercise. By each of these three criteria, physical activity was monotonically related to HDL cholesterol and TG: the most physically active men had the highest HDL cholesterol and lowest TG levels. With respect to physical activity outside of work, for example, mean HDL cholesterol and TG were 46.4 and 152.1 mg/dl, respectively, in the most active group, and 41.4 and 186.7 mg/dl in the most sedentary group. Physical activity remained significantly predictive of HDL cholesterol and TG when other known correlates of these plasma constituents--age, Quetelet index, plasma total cholesterol, cigarette smoking, alcohol intake, and clinic--were controlled individually by two-way analyses of variance or jointly by analysis of covariance. The association of physical activity with very low density lipoprotein cholesterol was parallel to but weaker than its association with TG. Low-density lipoprotein and total cholesterol were not significantly related to physical activity.

Adult↗