The effects of more frequent transfusions upon bone loss in thalassemia major.
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Adolescent↗
Biomedical subjects
J M Roseman
Publications and source records attributed to J M Roseman.
Epidemiology of low total plasma cholesterol concentration among young adults: the CARDIA study. Coronary Artery Risk Development in Young Adults.
BACKGROUND: Data on stability of plasma total cholesterol levels and its determinants among young adults are lacking. Knowledge of factors associated with low levels of plasma total cholesterol during young adulthood may help clarify the nature of associations between hypocholesterolemia and health or illness. METHODS: Tracking of plasma total cholesterol was investigated using data from the baseline (1985-1986), Year 5 (1990-1991), and Year 7 (1992-1993) examinations of the Coronary Artery Risk Development in Young Adults Study. Lifestyle (including dietary), physiological, medical, and psychological correlates of plasma total cholesterol were examined cross-sectionally at baseline using ANCOVA and multivariate logistic regression. The attributes of participants with persistently low plasma total cholesterol level after 7 years (i.e., remaining below the 10th percentile of sex- and race-specific distributions) were also examined. RESULTS: The cohort in this analysis comprised 720 black men, 922 white men, 899 black women, and 944 white women who were between the ages of 18 and 30 years at baseline. Between 44 and 52% of those with plasma total cholesterol levels below the 10th percentile remained below the same percentile 7 years later. Among black men, a difference of 1 SD in age [3.7 years; odds ratio (OR) = 0.69; 95% CI = 0.52-0.91] and a difference of 1 SD in systolic blood pressure (10.5 mm Hg; OR = 0.73; 95% CI = 0.54-0.97) were independently associated with lower odds, respectively, of being in the lowest 10th percentile of the plasma total cholesterol distribution. Also among black men, current smoking and more calories from carbohydrates were associated with nonsignificantly higher odds of low total cholesterol level. Among white men, a 1 SD older age (3.4 years; OR = 0.78; 95% CI = 0.61-1.00) and a 1 SD higher physical fitness (118 sec; OR = 1.41; 95% CI = 1.09-1.82) predicted lower and higher odds, respectively, of low plasma total cholesterol. Among black women, a 1 SD difference in albumin (0.3 g/dL; OR = 0.80; 95% CI = 0.63-1.03) was related to lower odds of low plasma total cholesterol. Among white women, the factors independently associated with low plasma total cholesterol were body mass index (OR for a difference in 4.0 kg/m2 = 0.73; 95% CI = 0.54-1.00) and gamma-glutamyl transferase (OR for an increase in 9.6 IU/L = 0.41; 95% CI = 0.18-0.93). The independent predictive factors of stably low total cholesterol levels were age and uric acid among black men (both inversely related) and age, Framingham Type A Behavior (inversely), and calories from carbohydrates (positively related) among white men. CONCLUSION: Young adults with low plasma total cholesterol level have characteristics generally associated with good cardiovascular health. However, adverse attributes such as current cigarette smoking (notably among black men) may confound future associations between low total cholesterol and disease.
Adolescent↗
Association of fasting insulin with blood pressure and lipids in young adults. The CARDIA study.
The association of insulin with cardiovascular disease (CVD) may be mediated in part by the associations of insulin with CVD risk factors, particularly blood pressure and serum lipids. These associations were examined in 4576 black and white young adults in the CARDIA Study. Fasting insulin level was correlated in univariate analysis with systolic blood pressure (r = 0.16), diastolic blood pressure (r = 0.13), triglycerides (r = 0.27), total cholesterol (r = 0.10), high density lipoprotein (HDL) cholesterol (r = -0.25), and low density lipoprotein (LDL) cholesterol (r = 0.14), and with age, sex, race, glucose, body mass index, alcohol intake, cigarette use, physical activity, and treadmill duration (all p less than 0.0001). After adjustment for these covariates, insulin remained positively associated with blood pressure, triglycerides, total and LDL cholesterol, and apolipoprotein B and was negatively associated with HDL, HDL2 and HDL3 cholesterol, and apolipoprotein A-I in all four race-sex groups. Higher levels of fasting insulin are associated with unfavorable levels of CVD risk factors in young adults; these associations, though relatively small, can be expected to increase the risk of atherosclerosis. Demonstration of these relationships in a large, racially diverse, healthy population suggests that insulin may be an important intermediate risk factor for CVD in a broad segment of the U.S. population.
Adolescent↗
True aneurysm of the profunda femoris artery. Literature review, differential diagnosis, management.
Aneurysms of the profunda femoris artery rarely occur as isolated lesions. Those cases appearing in the literature generally include only false aneurysms, the result of blunt, penetrating, or high velocity trauma. From a thorough review of the literature, true, aneurysmal dilatation of this artery, even as part of a generalized vascular degenerative process, must be considered obscure. A patient with an aneurysm of the deep femoral artery presented with an enlarging, progressively debilitating mass. The true nature of the lesion escaped definitive diagnosis even after detailed evaluation prior to surgical intervention. A review of the pathophysiologic basis of aneurysm formation strongly suggests this case may be the result of an, as yet undefined, autoimmune process.
Adult↗
Validity of the mother's recall of her child's antibiotic use.
We compared the mother's recall of her child's antibiotic use with the information obtained from the child's health records, while studying the association between antibiotic use and prevalence of mutans streptococci among 102 (5-12 years) inner-city black children. Poor recall of the mother (concordance ratio = 62 percent; kappa = 0.18, p = 0.06) and the lower frequency reported by her (p = 0.02) biased the positive association between child's antibiotic use during the second year of life and oral presence of mutans streptococci toward the null value (Odds Ratio [OR] based on health records = 3.1, 95 percent Confidence Interval [CI] = 1.03-9.3; OR based on mother's recall = 1.6, 95 percent CI = 0.44-5.8). Multiple logistic regression analysis failed to identify any significant determinant of the accuracy of the mother's recall. Since mothers considerably underestimate child's use of antibiotics, at least among inner-city low income blacks, this method of data collection should be limited to circumstances where no other options are available, and such results should be interpreted with caution.
Adolescent↗
Distribution and determinants of mutans streptococci among African-American children and association with selected variables.
Prevalence of mutans streptococci (MS) and the effect of selected variables, including the early childhood use of antibiotics on the oral colonization of MS, were studied among 353, 5- to 12-year-old African-American children using a cross-sectional study. MS prevalence was estimated using pooled plaque and stimulated saliva samples (spatula). Data on antibiotic use and other potential determinants of oral colonization of MS were obtained using a self-administered questionnaire. Antibiotic data were validated using health records of subjects. MS prevalence (92%, 95% Confidence Interval [CI] = 89-95%) was associated with dental caries (Odds Ratio [OR] = 2.5, 95% CI = 1.3-6.2), age (Chi for trend = 4.3, P = 0.04), increased frequency of sweet consumption (Chi for trend = 5.1, P = 0.02), and increased number of teeth in the mouth (unit OR = 1.3, 95% CI = 1.1-1.6). Higher MS levels were associated with higher number of decayed teeth (P < 0.0001), and also, with having the mother as the primary caregiver during the second year of life (P = 0.02). Furthermore, children who took antibiotics during early childhood and those who lived in the same household with many others during the second year of life had a higher MS prevalence than those who did not (OR = 8.3, 95% CI = 2.0-35.0; unit OR = 1.5, 95% CI = 1.03-2.2, respectively). It is unclear why those exposed to antibiotics during the "window of infectivity" of MS exhibit a higher MS prevalence. Antibiotic-related oral ecological changes (i.e, lower levels of S. sanguis) and environmental changes (i.e., frequent exposure to sugar through most pediatric antibiotic preparations) may make the oral cavity more favorable for initial MS colonization.
Black or African American↗