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Biomedical subjects

G D Friedman

Publications and source records attributed to G D Friedman.

At least 163 records · Page 9Linked to original sources
PubMed1982

Phenylbutazone, musculoskeletal disease, and leukemia.

Four hundred and nine patients age 30 and over with leukemia or lymphoma and a subset of 127 patients with myelocytic leukemia were compared with equal numbers of matched hospitalized control subjects and matched subscribers to the Kaiser-Permanente Medical Care Program (member controls). Prior use of phenylbutazone was somewhat more frequent in cases than in member controls only, but the difference was not statistically significant and the association appeared to be explained by an underlying relation of musculoskeletal disease to these lymphohematopoietic cancers. The association of musculoskeletal disease with myelocytic leukemia was present even when attention was restricted to the period at least two or five years before leukemia diagnosis. There was no clear association of amount and duration of phenylbutazone therapy with risk of leukemia. Several other drugs used for musculoskeletal conditions showed positive or negative relations to subsequent leukemia.

Acetaminophen↗
PubMed1982

The frequency of kidney and urinary tract diseases in a defined population.

The frequencies of kidney and urinary tract diseases (KUTD) in a defined population are presented. Rates of first hospitalizations with KUTD in the 5-year period, 1971 through 1975, were determined among over 1 million members of the Kaiser Foundation Health Plan (KFHP) of Northern California. Cases were identified from computer-stored ICDA-coded final discharge diagnoses for hospitalizations. Kidney and other urinary tract diseases were final diagnoses in 35.7 first hospitalizations per 10,000 members per year in the period 1971 through 1975. Disease-specific rates were highest for urinary tract infections, benign prostatic hypertrophy, and renal and ureteral calculi. The frequency of KUTD in this population is compared to available rates from other sources.

Adolescent↗
PubMed1982

Frequency of urolithiasis in a prepaid medical care program.

The rate of occurrence of stones of the urinary tract was assessed in a large population served by the Northern California Kaiser Foundation Health Plan. The study involved three separate groups. First, data were obtained by questionnaire from approximately 175,000 adults who took a multiphasic health checkup in the period 1964-1972; of these generally well adult members, 26.2/1000 persons (32.0/1000 men and 21.0/1000 women) reported having ever been told by a physician that they had a urinary tract stone. Second, data were obtained from 139,000 persons served by the San Francisco outpatient facility in 1970-1972; 1.22/1000 per year (1.81/1000 men and 0.59/1000 women) had an initial diagnosis of a "new or recurrent" stone of the upper urinary tract. The third set of data was procured from the entire Northern California region in 1971-1975; 0.36/1000 (0.52/1000 men and 0.19/1000 women) were discharged from a hospital each year with a diagnosis of upper urinary tract stone. All rates were age-adjusted to the 1960 US Census population. Of these three rates, the rate derived from the outpatient visit record most closely estimates incidence, since nearly all persons who are hospitalized are first seen as outpatients. Rates of kidney stone diagnosis were three times more common in men and, although rare before 20 years of age, the frequency increased rapidly and peaked in the age group 40 to 59 years. Rates were approximately twice as high in whites as in blacks and Orientals; the frequency of stones was inversely related to socioeconomic status as measured by level of education. Over 90% of stones occurred in the upper urinary tract, and the majority contained calcium oxalate. Population-based rates of occurrence of kidney stones are not generally available in the United States. Comparisons with the few available studies indicate that rates in the Kaiser Foundation Health Plan population may be high.

Adolescent↗
PubMed1982

A survey of personal habits, symptoms of illness, and histories of disease in man with and without vasectomies.

Using questionnaire information provided by 4.385 vasectomized and 13,155 matched, non-vasectomized men, we found no significant differences between them for a large number of symptoms and diseases, including those of the cardiovascular system. After taking into account differences in their martial status, past smoking habits, and physical activity at work, significant statistical associations of vasectomy with joint pain or swelling, back trouble, and a history of kidney or bladder infection persisted. Our data are inconsistent with the occurrence of large increases in the risks of many important diseases in vasectomized humans.

California↗
PubMed1982

Characteristics of patients referred for treatment of end-stage renal disease in a defined population.

We studied the incidence of referral for treatment of end-stage renal disease (ESRD) in the Kaiser Foundation Health Plan (KFHP) in northern California from 1972 through 1977. In this population of over 1 million persons, we found an age-adjusted annual incidence of 44.9 per million after 1973, when the Federal ESRD Program went into effect. Age-specific incidence was highest in in men greater than 70 years of age and in women in the 50- to 59-year age group; the male/female ratio was 1.4:1. The most common diagnoses of patients referred with ESRD were glomerulonephritis (11.4 per million per year), diabetic nephropathy (5.0 per million per year), primary hypertensive disease (3.1 per million per year), and polycystic kidney disease (2.4 per million per year). Estimated rates of referral for ESRD were highest for Blacks, lowest for Whites, and intermediate for Asians. Incidence varied by geographic area within the health plan service area and was highest where the percentage of the Black population was highest.

Adolescent↗
PubMed1982

Breast cancer and serum cholesterol.

Recent studies have suggested a role for dietary fat in the etiology of breast cancer. The relation of serum cholesterol and other serum lipid measures to breast cancer incidence was investigated in a cohort of 95, 179 women who had multiphasic health checkups from 1964 through 1972. Through 1977, 1,035 new breast cancer cases occurred in over 752,000 person-years of follow-up. Age-adjusted incidence rates were 1.45, 1.37, 1.31, and 1.40/1,000 person-years from the lowest to the highest quartile of serum cholesterol level, respectively. Similarly, no statistically significant relation was detected between beta-lipoprotein or total lipids and breast cancer. The sample size was sufficiently large to have detected a relative risk of 1.4 or larger with a probability of 99.9% at the 0.05 level of significance. The expected relation od breast cancer to established risk factors was confirmed by univariate analysis, and serum cholesterol and breast cancer were not associated after simultaneous consideration of nine other risk factors by multivariate analysis. These data suggest that the postulated causal relation between dietary fat and breast cancer does not act via an effect on circulating lipid levels.

Adolescent↗
PubMed1981

Periareolar subpectoral augmentation mammaplasty.

A modification of an established technique to augment the breast is described. Thirty patients underwent subpectoral augmentation though a periareolar incision with a follow-up period of 10 to 16 months. The purpose was to combine the benefit of subpectoral placement (to minimize capsular contracture) with an inconspicuous scar, which usually results from the periareolar approach. Under general anesthesia a periareolar incision was used. Dissection proceeded straight down to the pectoralis muscle, which was split between its fibers to enter the areolar subpectoral plane. The origin of the muscle from the ribs and part of the sternum was detached and the pocket was subcutaneously extended lateral to the muscle. Thus a larger than otherwise expected implant could be inserted without the problem of displacement by the muscle, Postoperative tonometry was done to quantitate the degree of breast softness. Initial results suggested that (1) the incidence of capsular contracture can be reduced by virtue of using th subpectoral plane; (2) breast tonometry measurements of brest softness or firmness correlate well with the clinical impression; (3) the periareolar scar is superior to the inframammary scar; and (4) the periareolar approach allows easy access to the subpectoral plane and allows for better visualization of the muscular detachment.

Breast↗
PubMed1981

Accuracy of information on smoking habits provided on self-administered research questionnaires.

In the setting of a prepaid medical care plan, self-administered questionnaires were an accurate source of information on smoking habits and the standard against which the physiologic measures of smoking, serum thiocyanate, and expired carbon monoxide, must be judged. Questionnaire responses were internally consistent and highly reproducible. In contrast, the physiologic measures had low overall sensitivity as tests of current tobacco exposure (0.72). Their sensitivity was improved by utilizing the self-reported information.

Adolescent↗
PubMed1981

Alcohol and mortality. A ten-year Kaiser-Permanente experience.

We studied 10-year mortality in relation to baseline alcohol use habits among four groups of 2015 persons, well matched for age, sex, race, and cigarette smoking. Persons reporting daily use of two drinks or fewer fared best; the heaviest drinkers (six or more drinks) had a doubled mortality rate, and users of three to five drinks had a mortality rate, and users of three to five drinks had a mortality rate approximately 50% higher. The nondrinkers had a mortality rate similar to that of users of three to five drinks per day. Cancer, cirrhosis, accidents, and nonmalignant respiratory conditions contributed significantly to the excess mortality of the heavier drinkers; coronary disease mortality was significantly higher among nondrinkers. Smoking intensity was a possible factor in the increased mortality of heavier drinkers, but the data were also compatible with the hypothesis that smoking and drinking are synergistic in the production of certain cancers and nonmalignant chronic respiratory illness. Other traits associated with alcohol use or abstinence are possible contributors to the excess mortality of both heavy drinkers and nondrinkers.

Adult↗
PubMed1981

Barbiturates and lung cancer in humans.

In a hypothesis-generating study looking for possible carcinogenic effects of drugs in humans, each of three barbiturates (pentobarbital sodium, phenobarbital, and secobarbital sodium) showed a statistically significant association with the subsequent development of lung cancer, with relative risks ranging from 1.5 to 2.8. Further analysis showed that the association was not explained by the increased prescription of barbiturate drugs shortly before the diagnosis of lung cancer or by an association of barbiturate use with cigarette smoking. Much of the data did not support a causal relationship. Neither a relation of lung cancer to duration or intensity of use not one between barbiturate use and a specific histologic type could be demonstrated.

California↗
PubMed1981

Alcohol use and cardiovascular disease: the Kaiser-Permanente experience.

Earlier studies of Kaiser-Permanente data have indicated that regular use of alcohol is associated with a reduced risk of major coronary events and that regular use of three or more drinks is associated with an increased prevalence of hypertension. A new study of hospitalizations in relation to alcohol use confirms this disparity in relations between alcohol use and cardiovascular disease and suggests that alcoholic cardiomyopathy has a relatively low incidence. An inverse relation between alcohol use and hospitalizations for cholelithiasis raises the possibility of a common pathogenic mechanism linking alcohol to coronary events and cholelithiasis. Overall risk of cardiovascular disease seems lower among users of two or fewer drinks daily than among either nondrinkers or heavier drinkers.

Adult↗