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Biomedical subjects

G D Friedman

Publications and source records attributed to G D Friedman.

At least 199 records · Page 11Linked to original sources

Clindamycin and diarrhea.

Of 298 outpatients receiving clindamycin for a variety of indications, diarrhea developed in ten (3.4%); none were diagnosed as having pseudo-membranous colitis. This is well within the range of relative frequencies of diarrhea development (0% to 22.2%) reported in 45 previous studies. Reliance solely on computer-recorded instances of diarrhea yielded a substantial underestimate of diarrhea occurence, but the rate was still significantly higher (P less than .05) in clindamycin users than in nonusers.

Acne Vulgaris↗

Lung function and risk of myocardial infarction and sudden cardiac death.

In a serach for risk factors for myocardial infarction and sudden cardiac death, the mean total vital capacity as measured at multiphasic health checkups was lower in persons who later had a first myocardial infarction than in risk-factor-matched controls (3.17 vs. 3.29 liters, 395 pairs, P less than 0.05) and non-risk-factor-matched controls (3.16 vs. 3.41 liters, 401 pairs, P less than 0.001). Findings were little affected by age and height adjustment and were similar for sudden cardiac death. The first-second vital capacity was also inversely related to later development of these conditions, but the ratio of that measurement to total vital capacity was not. Heavy smoking, productive cough, exertional dyspnea and cardiac enlargement were associated with diminished total capacity. However, exclusion of subjects with these findings did not reduce the predictive value of total vital capacity. Diminished vital capacity deserves continued attention as a possible coronary risk factor. Its relation to subsequent coronary events is not well explained.

Adult↗

Medical usage and abusage: "prevalence" and "incidence".

In view of the frequent misuse of the term "incidence," the concepts of incidence, prevalence, and period prevalence are defined and illustrated. The importance of restricting "incidence" to the rate of development of new events in a population or a group of patients, per unit of time, is stressed. Clearly distinguishing incidence from prevalence or simple proportion can help both in the understanding and the communication of findings in patient groups.

Epidemiology↗

Characteristics of heavy users of outpatient prescription drugs.

One hundred fifty-eight users of eight or more different prescription drugs in a three-month period were identified, using computerstored pharmacy data. Compared with 99 "light" users of only one or two different drugs, these heavy users were more likely to be older, female, and white and to have blue collar occupations, if male, or to be housewives, if female. Heavy drug use was associated with greater use of other medical care and was usually a persistent characteristic. Prepayment for drug prescriptions was not associated with heavy use. Among heavy users were found some severely ill individuals, and some with emotional problems that appear to contribute to symptoms and requests for drugs. In a 21-month period, adverse drug reactions were experienced by 28% of heavy users as compared with 8% of light users.

Adult↗

Cigarette smoking and chest pain.

Analysis of questionnaire responses of 70208 persons undergoing multiphasic health checkups showed a greater proportion of cigarette smokers than nonsmokers (excesses averaging 1.6-fold in white men, 1.3-fold in white women) admitting to nine types of chest pain. This excess in smokers was greater in younger individuals, and applied about equally to anginalike and nonanginalike pain. The smoking/chest pain association was not explained by greater alcohol or coffee consumption, diminished pain tolerance, or less reliability among smokers; nor did it appear to be mediated chiefly by excess cough, shortness of breath, coronary disease, or musculoskeletal complaints in smokers. Although smokers averaged more complaints than nonsmokers, chest pain resembled clearly smoking-related symptoms, such as cough, when the number of each subject's complaints was considered. Although more smokers had chest pain no type of pain was unique to smokers, suggesting that the "tobacco angina" concept be discarded or reserved for rare patients with coronary heart disease in whom smoking clearly provokes angina pectoris.

Adolescent↗

Predictors of sudden cardiac death.

A search was made for predictors of sudden cardiac death (SCD) among 197 men, age 40 to 79, who had multiphasic health checkups and experienced SCD 2 days to 5 1/2 years later (mean 18.1 months). Two age-sex-race-matched control groups, one matched and one unmatched for standard coronary risk factors, have been compared to the cases. In this ambulatory population, SCD occurred largely in persons with prior diagnosed heart disease. Standard coronary risk factors were confirmed as predictors of SCD. Predictors among other laboratory and quantitative tests include chylous serum, uric acid, hemoglobin, leukocyte count, pulse rate, diminished lung volumes, and hearing loss. Some of these had predictive value independent of standard risk factors. Pain tolerance was not related to SCD or to death in, versus out of hospital. Most of these predictors were not related to terminal symptom duration; this suggests a relationship more to the underlying atherosclerotic process than to the terminal fatal mechanism.

Adult↗