Search PubMed⌕ Search

Biomedical subjects

G D Friedman

Publications and source records attributed to G D Friedman.

At least 127 records · Page 7Linked to original sources
PubMed1988

A fresh look at the open rhinoplasty technique.

Use of the open rhinoplasty technique (ORT) in certain nasal and septal deformities has proven to be an invaluable asset in the rhinoplasty armamentarium of the authors. Primarily owing to the markedly increased exposure with this technique, more accurate assessment of the deformities is possible and additional or improved surgical maneuvers become available, particularly in the tip. Sculpting the entire cartilaginous and/or bony vault, as well as correcting difficult septal malalignments, can be carried out under better direct vision with greater precision, accuracy, and predictability. This has led to improved and more consistent final results. Previous criticisms of unsightly columellar scars have been virtually eliminated through the use of improved surgical techniques and simple magnification. Overall, open rhinoplasty technique can provide many distinct advantages in certain nasal deformities with no real disadvantages over conventional closed techniques.

Adolescent↗
PubMed1988

Cancer of the large bowel after cholecystectomy.

The possibility that cholecystectomy may increase the risk of developing cancer of the large bowel has been a matter of concern for several years. The association has biological plausibility because of the effects of cholecystectomy on the formation of secondary bile acids. Recent evidence, however, suggests that the association is absent or weak. This underlines the recommendation that biological explanations should not be relied upon too heavily when considering epidemiological associations.

Animals↗
PubMed1987

Cholecystectomy and large bowel cancer.

The records of 5898 patients with colorectal cancer and 27,687 controls were examined for previous cholecystectomy. The estimated relative risks (and 95% confidence intervals) of development of any cancer of the large bowel and cancer of the right colon after cholecystectomy were 1.0 (0.8-1.2) and 1.1 (0.8-1.5) in women and 1.1 (0.9-1.5) and 1.2 (0.8-1.9) in men, respectively. Although these data do not rule out a small increase in risk, it is proposed that the association found in some other studies is, at least in part, an artifact. Intense diagnostic effort and treatment aimed at mild abdominal symptoms, encouraged by some patients and some medical care settings, could increase the detection and removal of gallstones and the early detection of colorectal cancer.

Adult↗
PubMed1987

Concordance for type 2 (non-insulin-dependent) diabetes mellitus in male twins.

Concordance for Type 2 (non-insulin-dependent) diabetes was determined in 250 monozygotic and 264 dizygotic white male twin pairs who participated in the National Heart, Lung, and Blood Institute Twin Study. These twins were born between 1917 and 1927 and were identified from military records without regard to disease status. We examined surviving members of the cohort twice--at mean ages of 47 and 57 years--and obtained 1-h post-load glucose tests and medication histories. Diagnostic criteria for Type 2 diabetes included a glucose value greater than or equal to 13.9 mmol/l or current use of antidiabetic medication; possible Type 1 (insulin-dependent) diabetic twins were excluded. A strong genetic predisposition to Type 2 diabetes was suggested by 3 lines of evidence from the second examination: (1) 58% of monozygotic co-twins of diabetic twins were themselves diabetic compared with an expected prevalence of 10%; (2) only 1 of 15 originally disease-discordant, monozygotic twin pairs remained discordant for diabetes; and (3) 65% of non-diabetic monozygotic co-twins of diabetic twins had elevated glucose values. Because concordance for diabetes was less than 100% for twins aged 52-65 years and because twins varied in age at onset of disease, non-genetic factors may also influence diabetes development. Among the 19 monozygotic twins pairs discordant for diabetes, diabetic twins did not differ from their non-diabetic co-twins in obesity, diet, alcohol consumption, or education. However, compared with unrelated non-diabetic twins of the same ages, non-diabetic co-twins of diabetic twins gained more weight as adults (p less than 0.02) and had higher glucose levels (p less than 0.03).

Body Weight↗
PubMed1987

Recruitment in the Coronary Artery Disease Risk Development in Young Adults (Cardia) Study.

Coronary Artery Disease Risk Development in Young Adults (CARDIA) is a longitudinal study designed to trace the development of risk factors for coronary heart disease in 5100 individuals 18-30 years old. The study will compare, by cross-sectional and longitudinal analyses, trends and processes involved in risk factor development by sex, race, age, and other sociodemographic characteristics. Participants for the approximately 4 1/2-hour baseline examination were randomly selected and recruited by telephone from census tracts in Minneapolis and Chicago, by telephone exchanges within the Birmingham city limit, and from lists of the Kaiser-Permanente Health Plan membership in Oakland and Berkeley. A major issue was the desirability of sampling approximately equal numbers by age, race, sex, and education as compared with sampling numbers representative of the population base. The recruitment goal of 5100 was achieved on schedule.

Adolescent↗
PubMed1987

Risk factors for coronary heart disease in adult female twins. Genetic heritability and shared environmental influences.

The contributions of shared genes and shared environments to familial aggregation of coronary heart disease risk factors were investigated by genetic and epidemiologic analysis of 434 adult female twin pairs from the Kaiser-Permanente Twin Registry in Oakland, California, during 1978 and 1979. Initial estimates of genetic heritability were statistically significant for serum levels of high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, and Quetelet index, but were only marginally significant for systolic and diastolic blood pressures. These estimates were biased, however, because sisters in the same identical twin pair were more similar than sisters in the same fraternal twin pair not only with respect to shared genes but also with respect to shared environmental and behavioral influences. Heritability was estimated again after adjusting for shared environmental and behavioral effects by multiple regression analysis. Genetic heritability remained significant for HDL cholesterol (0.66), LDL cholesterol (0.88), triglycerides (0.53), and relative weight (0.55) but not for systolic (0.42) and diastolic (0.25) blood pressures. The strong genetic components of the levels of LDL cholesterol, HDL cholesterol, and relative weight may in part explain why some women have high levels of these coronary disease risk factors despite following recommended health behaviors.

Adult↗
PubMed1987

Environmental and behavioral determinants of fasting plasma glucose in women. A matched co-twin analysis.

Comparing results of an unmatched analysis in a sample of unrelated persons created by randomly selecting one twin from each pair with results of a matched monozygotic co-twin analysis provides a means of distinguishing environmental influences from genetic influences on a dependent variable of interest. Determinants of the fasting plasma glucose level were investigated in a large sample of adult female nondiabetic twins from the Kaiser Permanente Twin Registry. In the subsample of unrelated persons, fasting plasma glucose was significantly and positively associated with age, body mass index, uric acid level, and alcohol intake and was significantly inversely related to leisure time physical activity. When monozygotic twins were treated as matched pairs, only the effects of body mass index and alcohol consumption remained significant, whereas the association with leisure time physical activity was greatly reduced and no longer statistically significant. These results suggest that behavioral and therefore alterable aspects of obesity and alcohol consumption influence the fasting plasma glucose level; alcohol consumption may be a risk factor for non-insulin-dependent diabetes mellitus; and common underlying genetic factor(s) may be responsible for the negative association between physical activity and fasting plasma glucose.

Adult↗
PubMed1987

Thinness and mortality.

The relationship of thinness to mortality was examined in White adult members of the Kaiser Permanente Medical Care Program who had at least three multiphasic health checkups between 1964 and 1972, with mortality follow-up through 1980. A detailed comparison was performed of the mortality patterns of "thin" (decile 1 of Quetelet's index) and "average" weight (deciles 4 and 5) cohort members who were age 40-79 years and free of illness at the beginning of follow-up. Thin male (relative risk 1.6, 95 per cent confidence limits 1.0, 2.6) and female (R.R. 2.1, 95 per cent C.L. 1.1, 3.9) current cigarette smokers were at increased risk of mortality compared with average weight smokers. Unmeasured differences between thin and average weight smokers with respect to quantity of cigarettes smoked may have contributed to the apparent association of thinness with mortality in smokers. Thinness was not associated with increased mortality in never smokers and ex-smokers (R.R. 1.0 in men and women). As association of long-term weight loss with mortality was present in thin and average weight men and in thin women.

Adult↗
PubMed1986

Relations of alcoholic beverage use to subsequent coronary artery disease hospitalization.

Unresolved questions about the inverse relation between alcohol consumption and coronary artery disease (CAD) include; Dose past drinking have a role in the apparently higher CAD risk of abstainers? Is the lower CAD risk found only among lighter drinkers? Does type of alcoholic beverage matter? Are abstainers at higher risk of CAD because symptoms or illness cause many to quit drinking? In a prospective study among 85,001 health examinees giving an alcohol history at a health examination from 1978 through 1982, 756 persons were later hospitalized for CAD in the same years. Using lifelong abstainers as the reference group and controlling for age, sex, race, smoking, coffee drinking and education, analysis showed that past drinkers and very infrequent drinkers had CAD risk similar to that of lifelong abstainers. A significantly and progressively lower CAD risk was found at higher drinking levels. Preference for wine, liquor or beer had no major independent effect. A subset of persons apparently free of CAD and other recent major illnesses showed a similar alcohol-CAD relation. Thus, this study suggests a negative answer to the 4 questions above and supports the view that alcohol protects against CAD. As most of the apparent protection was present at a daily intake of 1 to 2 drinks/day, an amount generally regarded as safe for most persons, the findings should not be used to justify heavier drinking.

Alcohol Drinking↗
PubMed1986

Multiphasic Health Checkup Evaluation: a 16-year follow-up.

The Multiphasic Health Checkup Evaluation Study, a long-term clinical trial, has been completed. A study group of 5156 men and women age 35-54 at entry was urged to have annual multiphasic health checkups (MHCs) for 16 years. A control group of 5557 comparable subjects was not so urged but was followed up in a comparable fashion. The mean and median number of MHCs per person were 6.8 and 6, respectively, in the study group and 2.8 and 1, respectively, in the control group. During 16 years the study group experienced a 30% reduction (p less than 0.05) in deaths from pre-specified "potentially postponable" causes, largely associated with lower death rates from colorectal cancer and hypertension. This reduction was most pronounced in the early years of the study. The two groups did not differ to a statistically significant degree in mortality from all other causes (84% of total mortality) or in total mortality. There was no difference in self-reported disability in the overall groups. In the setting of our prepaid health care plan where MHCs were already available on a voluntary basis, a program of urging middle-aged persons to undergo regular MHCs brought about a substantial reduction in mortality from preselected diseases.

Adult↗
PubMed1986

Serum retinol and retinol-binding protein levels do not predict subsequent lung cancer.

Retinol and retinol-binding protein levels were measured in sera previously obtained, and stored in the frozen state, at multiphasic health checkups from 151 persons subsequently found to have lung cancer (cases) and 302 persons who remained free of cancer (controls). Two controls were matched to each case for sex, skin color, age, date of multiphasic health checkup, and aspects of the smoking habit. Mean levels in cases and controls were, respectively, retinol: 82.17 and 82.37 micrograms/dl (p = 0.93), and retinol-binding protein: 6.04 and 6.00 mg/dl (p = 0.81). Mean differences between cases and controls were, retinol: 0.195 micrograms/dl with 95% confidence limits, -3.91 and 4.30 micrograms/dl; retinol-binding protein: -0.033 mg/dl with 95% confidence limits, -0.31 and 0.24 mg/dl. No significant trend in relative risk of lung cancer was observed when the retinol or retinol-binding protein distribution was divided into quintiles. No significant associations were observed in subgroups based on age, sex, histologic type of cancer, cigarette consumption, or interval between blood drawing and cancer diagnosis. In this large study, retinol and retinol-binding protein levels were not useful in predicting the subsequent development of lung cancer.

Adult↗
PubMed1986

Serum cholesterol and large bowel cancer. A case-control study.

A case-control study of the relationship of serum cholesterol to large bowel cancer incidence was performed for 245 members of the Kaiser Permanente Medical Care Program in northern California. Five controls were obtained for each case, matched for age, sex, race, and time of examination. The mean serum cholesterol levels of cases were not significantly different from those of controls for all colorectal cancers, right-sided colon cancers, and left-sided colon cancers. Analysis by quartiles of serum cholesterol level suggested neither a direct nor an inverse relationship between serum cholesterol and large bowel cancer, and there was no evidence of a threshold value below which the risk of cancer increased. The study did not support the findings from other studies of an inverse relationship between serum cholesterol and large bowel cancer.

Adult↗
PubMed1986

The relationships between alcoholic beverage use and other traits to blood pressure: a new Kaiser Permanente study.

In a new study controlled for many factors, we reconfirmed the relationship of higher blood pressure to alcohol use. This relationship was slightly stronger in men, whites, and persons 55 years of age or older. A slight increase in blood pressure appeared in men who drank one to two drinks daily, and a continuous increase occurred at all higher drinking levels among white men who had constant drinking habits. Among women, an increase occurred only at three or more drinks daily. The data suggest complete regression, beginning within days, of alcohol-associated hypertension upon abstinence. Blood pressure showed minor differences with beverage preference: those who preferred liquor had higher adjusted mean blood pressure than those preferring wine or beer. The results of this study contribute to the likelihood that the alcohol-blood pressure association is causal. Smoking, coffee use, and tea use showed no association with higher blood pressure. Systolic pressure showed a positive relationship to total serum calcium and an inverse relationship to serum potassium, but diastolic pressure showed little relationship to these blood constituents; the explanations include a possible direct effect on regulation of blood pressure.

Adipose Tissue↗
PubMed1986

Smoking habits among multiphasic examinees, 1979 to 1984.

In tabulating the smoking habits of 95,744 residents of the San Francisco Bay Area, as reported between July 1979 and June 1984 at multiphasic health checkups, the prevalence of current smoking was found to be higher in men than in women aged 30 years and above, but in those younger than 30 the reverse was true. In every age group, compared with male smokers, female smokers tended to smoke fewer cigarettes per day, to inhale less and to smoke cigarettes with lower tar and nicotine yield. Blacks showed the highest percentage of smokers, whites were second highest and Asians were lowest, with Asian women being substantially lower than other race-sex groups. On average, white smokers smoked more cigarettes per day and inhaled more than did black smokers, but whites were more apt to smoke low-yield cigarettes. Compared with a 1964 to 1968 study in the same setting, there has been a decrease in the prevalence of cigarette smokers but, among smokers, a higher proportion in 1979 to 1984 smoked at least 20 cigarettes per day. During the 1979 to 1984 period, there were small downward trends in the prevalence of cigarette smoking in men and white women and in the prevalence of heavy smoking among male smokers, but there was no apparent increase in the use of lower-yield cigarettes by smokers. Although this study group contained relatively fewer smokers, most of the age, sex and racial differences and long-term trends parallel what has been observed nationally.

Adolescent↗
PubMed1985

Cardiovascular and other diseases in smokers of low yield cigarettes.

The association of smoking low yield cigarettes with the risk of cancer, cardiovascular disease, and other disease associated previously with smoking is controversial. In 1979 we began a prospective epidemiologic study of this subject. We here report on the first 4 years of follow-up in the 16,270 current, regular cigarette smokers and the 42,113 subjects who never used any form of tobacco enrolled in the study. In multivariate analyses that included age, sex, race, number of cigarettes smoked per day and other factors related to cardiovascular disease, the risk of cardiovascular diseases was consistently higher in smokers of higher than in smokers of lower yield cigarettes, although the magnitude of the difference in risk was very small. The risks of cancer of the trachea, bronchus and lung, of all smoking-related cancers as a group, of diseases of the respiratory system, and of peptic ulcer diseases were not significantly associated with yield in smokers. The incidence rates of cardiovascular diseases considered as a group, cancer of the trachea, bronchus, and lung and all smoking-related cancers were higher in smokers of low yield cigarettes than in never users of any form of tobacco. We conclude that the smoking of low yield cigarettes is not without associated hazard. On the other hand, the results suggest that smokers who cannot quit might best use the least number of the lowest yield cigarette.

Adult↗