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Biomedical subjects

J D Curb

Publications and source records attributed to J D Curb.

159 records · Page 9Linked to original sources
PubMed1983

Nosological coding of cause of death.

Death certificates representing 766 decedents who had participated in the Hypertension Detection and Follow-up Program (1973-1979) at one of 14 US centers were given to three nosologists for purposes of coding underlying cause of death. Analyses examined interobserver variability among the three nosologists as well as intraobserver variability for each of the three nosologists. All three nosologists agreed on a three-digit International Classification of Diseases, Adapted (ICDA) code in 90.2% of the cases and at least two out of three agreed in 99.7% of the death certificates examined. Agreement rates improved when disease codes were collapsed into broader categories utilized in the Hypertension Detection and Follow-up Program. When particular disease classifications (e.g., cerebrovascular, ischemic heart disease, myocardial infarction, and neoplasms) were examined, three out of three agreement rates were highest for neoplasms (97.8%) and lowest for myocardial infarction (86.5%). Similarly, two out of three agreement was highest for neoplasms (98.5%) and lowest for myocardial infarction (88.0%). Intranosologist agreement rates were based on a recoded 20% sample of death certificates. Agreement rates for three-digit ICDA codes ranged from 94.8% to 96.1% for the three nosologists. The agreement rates for the general disease categories ranged from 96.7% to 97.4%.

Cardiovascular Diseases↗
PubMed1983

An epidemiologic study on carcinoma of the breast following irradiation for benign conditions in infancy and childhood.

To investigate the relationship of irradiation during infancy and childhood to the subsequent development of carcinoma of the breast, 996 eligible patients were studied at Evanston Hospital, Evanston, Illinois, and Northwestern Memorial Hospital, Chicago. This was a case-control study, with those in the control group being selected from concurrent hospital admissions for nonmalignant surgical conditions. A second group consisting of those with benign biopsy results was also studied. The Mantel-Haenszel method of analysis, controlling for age and race, was used to estimate the approximate relative risk of carcinoma of the breast in the irradiated group compared with that for the nonirradiated group. The type of radiation history included radiotherapy for mastitis or enlarged thymus (nine patients), irradiation of the head and neck (69 patients), diagnostic fluoroscopies (ten patients) and miscellaneous irradiation (52 patients) for bursitis, eczema or keloid. Based upon the data obtained from the results of this study and its analysis, we conclude that there is little evidence of increased risk of carcinoma of the breast after irradiation about the head, neck and chest areas for benign conditions in the population being studied herein. Such a risk, if indeed it exists at all for this population, is estimated to be about 10 per cent.

Adult↗
PubMed1980

Lability of HDL-cholesterol during serum storage.

In many clinical and research situations it would be desirable to store, for extended periods, specimens on which measurements of high density lipoprotein cholesterol (HDL-C) levels were desired. To test the effects of storage on subsequent HDL-C levels, divided serum specimens from 46 subjects were frozen at -80 degrees C and analyzed at intervals throughout a 12-month period. A statistically significant increase in the HDL-C levels was found (P < 0.01). Thus, caution must be exercised in interpreting the results of HDL-C analysis done on specimens stored for prolonged periods even at -80 degrees C.

Blood Preservation↗
PubMedDate not supplied

Association of coffee and caffeine intake with the risk of Parkinson disease.

CONTEXT: The projected expansion in the next several decades of the elderly population at highest risk for Parkinson disease (PD) makes identification of factors that promote or prevent the disease an important goal. OBJECTIVE: To explore the association of coffee and dietary caffeine intake with risk of PD. DESIGN, SETTING, AND PARTICIPANTS: Data were analyzed from 30 years of follow-up of 8004 Japanese-American men (aged 45-68 years) enrolled in the prospective longitudinal Honolulu Heart Program between 1965 and 1968. MAIN OUTCOME MEASURE: Incident PD, by amount of coffee intake (measured at study enrollment and 6-year follow-up) and by total dietary caffeine intake (measured at enrollment). RESULTS: During follow-up, 102 men were identified as having PD. Age-adjusted incidence of PD declined consistently with increased amounts of coffee intake, from 10.4 per 10,000 person-years in men who drank no coffee to 1.9 per 10,000 person-years in men who drank at least 28 oz/d (P<.001 for trend). Similar relationships were observed with total caffeine intake (P<.001 for trend) and caffeine from non-coffee sources (P=.03 for trend). Consumption of increasing amounts of coffee was also associated with lower risk of PD in men who were never, past, and current smokers at baseline (P=.049, P=.22, and P=.02, respectively, for trend). Other nutrients in coffee, including niacin, were unrelated to PD incidence. The relationship between caffeine and PD was unaltered by intake of milk and sugar. CONCLUSIONS: Our findings indicate that higher coffee and caffeine intake is associated with a significantly lower incidence of PD. This effect appears to be independent of smoking. The data suggest that the mechanism is related to caffeine intake and not to other nutrients contained in coffee. JAMA. 2000;283:2674-2679.

Aged↗
PubMedDate not supplied

Weight change, survival time and cause of death in Dutch elderly.

Weight change, subsequent survival time and cause of death are reported from the Dutch Longitudinal Study among the Elderly. Data consist of a national sample of persons aged 65-99 years. Six hundred and fifty-eight subjects were examined in the baseline years 1955-1957 and were re-examined 5 years later. Vital status and cause of death were ascertained for 604 of these subjects through 1983. Those subjects who experienced a decline in body mass index (BMI, kg/m(2)) during the period of observation, were likely to be in poorer health and have a shorter survival time than those subjects with stable weight, regardless of initial BMI. Weight gain was associated with shorter survival time only in the age group 65-74 and in those with heart disease. Weight loss, on the other hand, was most likely to result in decreased survival time among those ultimately dying of stroke, pneumonia/influenza or heart disease. As such, weight loss may be an indicator of the severity of disease. The noted associations remained, even when those surviving less than two years were omitted from the analyses. Thus, in longer survivors, weight loss may be associated with decreased vitality and decreased ability to survive once a disease becomes apparent.

Journal Article↗
PubMedDate not supplied

Biological and dietary correlates of plasma lipids and lipoproteins among elderly Japanese men in Hawaii.

The relationships of plasma total cholesterol (total-C), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and triglyceride (TG) to a variety of personal attributes were investigated cross-sectionally in a random sample of approximately 1360 elderly Japanese men, aged 60-81 years, in Hawaii. In multivariate analyses, total-C was positively related to hematocrit (p less than 0.01); LDL-C was positively related to hematocrit (p less than 0.0001), and inversely related to alcohol consumption (p less than 0.0001); HDL-C was positively related to alcohol consumption (p less than 0.0001) and physical activity index (p less than 0.05), and inversely related to body mass index (p less than 0.0001) and antihypertensive medication (p less than 0.05); and LogTG was positively related to body mass index (p less than 0.0001), alcohol consumption (p less than 0.0001), antihypertensive medication (p less than 0.0001), and diastolic blood pressure (p less than 0.01), and inversely related to physical activity index (p less than 0.01). Body mass index and alcohol consumption were the most important correlates of plasma lipids and lipoproteins. Several dietary variables were significantly related to each lipid or lipoprotein fraction after controlling for nondietary variables, but their independent contributions were generally quite modest.

Aged↗
PubMedDate not supplied

Reserpine and breast cancer in the Hypertension Detection and Follow-Up Program.

Recent reports on the efficacy of pharmacological management in reducing mortality associated with mild hypertension have enhanced the importance of increasing our knowledge about drug toxicity. The Hypertension Detection and Follow-Up Program (HDFP) provides a convenient setting in which to examine the association reported between reserpine usage and breast cancer. In the intensively treated and followed group (Stepped Care [SC]), the relative breast cancer experience of those who did take reserpine and those who did not was examined. Of 2529 females in SC, 1036 received reserpine, with an average exposure of 1.97 years during 5 years of follow-up. Through extensive investigation, 21 cases of breast cancer were identified. using a life table regression method of analysis to adjust for actual time of reserpine exposure, race, sex, and medication status at entry, and comparing those who took reserpine with those who did not, the author's calculated a risk ratio of 1.28, with a confidence interval of 0.58 to 2.80. Adjustment for a number of other variables known to have relationships to breast cancer did not appreciably change the results. Thus, with certain precautions, the authors conclude that in this setting there is no indication of the recently postulated association of reserpine and the short-term enhancement of breast tumor growth.

Adult↗
PubMedDate not supplied

Training and certification of blood pressure observers.

Accurate, reproducible measurements of blood pressure (BP) were central to the goals and objectives of the Hypertension Detection and Follow-Up Program (HDFP), a multicenter clinical trial on the efficacy of pharmacological treatment of individuals with elevated BP. All potential BP observers with or without previous experience in measuring BP were required to undergo a defined training program and meet set performance criteria to be certified to take HDFP BP. Recertification was required twice a year. Originally an audiotape test was used to measure accuracy of BP readings. This approach was later replaced by a videotape test, which proved more realistic and an equally effective tool for long-term quality control. With this technique of certifications, 75% of the individuals taking the test passed on the first attempt and more than 95% passed with one or two attempts. Although agreement for blinded BP duplicates was generally good, the appearance of sound (systolic BP) was identified with greater reproducibility than was the disappearance (diastolic BP). These recertification procedures were of great value in assuring the continued high quality of our BP data.

Allied Health Personnel↗
PubMedDate not supplied

Patient-perceived side effects to antihypertensive drugs.

The Hypertension Detection and Follow-up Program (HDFP) used two methods to collect data on drug side effects. First, questions were asked during annual home visits by nontherapist interviewers, and second, responses were elicited by questionnaire at each clinic visit. Frequency of side effects as reported by the participants was similar in stepped care and referred care participants. Among the stepped care participants attending clinic, 75 percent continued to report at least one of the side effects reported at baseline. New symptoms (not previously reported) were less frequent, reported by 14 percent. Although medications were discontinued in 17 percent of the HDFP participants due to side effects, less than 2 percent of those reporting side effects had their drug discontinued for the symptom they reported. We concluded that questionnaire-elicited reports of drug side effects are a relatively poor index of side effects.

Antihypertensive Agents↗
PubMedDate not supplied

Assessment of double-blindness at the conclusion of the beta-Blocker Heart Attack Trial.

At the conclusion of a double-blinded, randomized clinical trial of propranolol hydrochloride, but before unblinding, the patients and clinic personnel were asked to guess the treatment group assignment of each patient. While 79.9% of the patients receiving propranolol correctly identified their treatment group assignment, 57.2% of the patients receiving placebo incorrectly guessed that they were also in the propranolol group. No specific mechanism was identified to explain why more patients receiving propranolol were better able to guess their group assignment. Clinic physicians correctly identified the group assignment of 69.9% of the patients receiving propranolol and 68.8% of the patients receiving placebo. Clinic coordinators correctly identified the group assignment of 67.1% of the patients receiving propranolol and 70.6% of the patients receiving placebo. For clinic personnel, heart rate level and heart rate change seem to be the mechanisms employed to identify their patients' treatment assignment.

Adult↗