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Biomedical subjects

M Feinleib

Publications and source records attributed to M Feinleib.

At least 55 records · Page 3Linked to original sources
PubMed1987

National trends in the morbidity and mortality of asthma in the US. Prevalence, hospitalization and death from asthma over two decades: 1965-1984.

National population-based data systems of the National Center for Health Statistics (NCHS) were used to study the epidemiology of asthma in the United States over the last 20 years. Asthma is more prevalent among males, those living below the poverty level, persons living in the South and West, and blacks; however, this difference did not attain statistical significance. Death rates from asthma among the older age groups probably increased between 1968 and 1982, with a substantial increase since 1979. For children, the evidence is less clear, but the death rate has increased for children over five years of age during the period from 1979 to 1982. Between 1964 and 1980, asthma has become more prevalent in children under 17 years of age, but this does not reflect an increase in the severity of asthma over this same time period. Hospitalization rates for asthma between 1965 and 1983 increased by 50 percent in adults and by over 200 percent in children. Rates for black patients are 50 percent higher in adults and 150 percent greater in children. It is concluded that there has been a marked increase in hospitalization rates for asthma, a moderate increase in death rates from asthma and a smaller increase in overall prevalence of the disease in the United States.

Activities of Daily Living↗
PubMed1986

Methodological issues in screening for dementia: the problem of education adjustment.

The methodological problems of developing efficient and unbiased screening methods for population-based studies of dementia have received scant attention. The potential advantages of education-adjusted screening methods are discussed. The implications for adjustment techniques of a negative correlation of educational attainment with age are emphasized. Two education adjustment methods, a stratified regression method and a nonparametric method, which take the age-education correlation into account are described, compared, and illustrated.

Age Factors↗
PubMed1985

A potential use of the National Death Index for postmarketing drug surveillance.

A particularly difficult problem for both the Food and Drug Administration and the pharmaceutical manufacturer is evaluation of the importance of spontaneous reports of suspected drug-associated fatalities. These reports are rare, and usually no accurate denominator data on drug use exist. This article proposes that the National Death Index be used to calculate mortality rates for selected drugs as part of the postmarketing surveillance efforts of the government and manufacturers. When hypotheses are generated from spontaneous reports and/or the mortality data, additional studies can be conducted on the cohorts that were identified for mortality follow-up.

Death Certificates↗
PubMed1985

Regression analysis of data with correlated errors: an example from the NHLBI twin study.

Epidemiologic studies often involve genetically related individuals, spouses, or repeat observations on the same individual. When regression analysis is required in such studies, significant correlation of the residuals may affect the estimates of the standard errors of the regression coefficients. Ordinary least squares may not provide the best (minimum variance) estimates of the regression coefficients. Generalized least squares (weighted least squares) is more appropriate when the covariance matrix of the errors is known or can be estimated with some degree of confidence. Data from a twin study of pulmonary function were analyzed by three different regression techniques and comparisons of the coefficients and standard errors are made to illustrate the potential effects of correlated errors.

Age Factors↗
PubMed1985

The relationship of dietary fat and cholesterol to mortality in 10 years: the Honolulu Heart Program.

This report examines the relationship of dietary fat and dietary cholesterol to mortality during a 10-year surveillance of a cohort of men of Japanese descent residing in Hawaii. The consumption of dietary fat (measured in grams) is related inversely and significantly to total mortality. No significant relationships exist between grams of dietary fat and any of the specific causes of death examined. No significant relationships are found between dietary saturated fatty acids (SFA, measured in grams) or dietary cholesterol (measured in milligrams) and any of the specific causes of death examined. In contrast, percentage of calories as fat is related inversely not only to total mortality, but to cancer mortality and to stroke mortality; and it is related directly to coronary heart disease (CHD) mortality. Percentage of calories as SFA is related inversely to cancer mortality and to stroke mortality, and it is related directly to CHD mortality. Only the relationship to stroke mortality remains significant in multivariate analysis if calories from alcohol are excluded from the computation. Dietary cholesterol per 1000 calories is related directly to CHD mortality. While these data provide support for the diet-heart hypothesis, they also suggest that men with low fat intakes have a higher total mortality rate than men with higher fat intakes. This increased risk, due to an excess risk of death from stroke and cancer, indicates that there is no overall beneficial effect from a low fat diet in this cohort.

Aged↗
PubMed1985

The association between cholesterol cholelithiasis and coronary heart disease in Framingham, Massachusetts.

A relationship between cholesterol gallstone disease and atherosclerosis or its sequellae has long been postulated but has never been adequately proven. Data for this investigation of the relationship of diagnosed cholesterol cholelithiasis to subsequent incident coronary heart disease were obtained from a review of the pre-existing prospectively collected medical records of the 5,209 individuals followed since 1952 as members of the original cohort of the Framingham Heart Study. Preliminary univariate examination of these data, making no correction for time ordering of the conditions or for shared risk factors, indicated a significant modest positive association in men but no relationship in women. Logistic multiple regression analyses, allowing for the effects of time ordering and for eight standard coronary disease risk factors, confirmed these findings. The authors speculate that the presence of cholesterol gallstones in male patients may be indicative of an unfavorable lipoprotein profile. These results have clinical implications in that male gallstone patients are at increased risk for subsequent coronary disease and should be monitored accordingly. This investigation marks the first time that a relationship between these conditions has been established using a longitudinal cohort study approach.

Adult↗
PubMed1985

Framingham Disability Study: relationship of disability to cardiovascular risk factors among persons free of diagnosed cardiovascular disease.

The relationship between physical disability and cardiovascular risk factors among persons free of diagnosed cardiovascular disease was examined. Between 1948 and 1951, a cohort of adult, Framingham, Massachusetts, residents was assembled for a longitudinal examination of cardiovascular disease. Twenty-seven years after the participants' initial examination (between 1976 and 1978), members of the cohort who were still participating in the Framingham Heart Study were interviewed to ascertain their self-assessed ability to perform various physical activities. A score on the cumulative disability index was assigned to 2,021 persons free of diagnosed cardiovascular disease. Analyses controlled for noncardiovascular health conditions which were identified as related to disability. Among women, both long-term and current hypertension and body mass index, as well as diabetes, were associated with disability. Among men, long-term hypertension was related to disability. Age-specific analyses indicated that, for women, current hypertension was statistically significantly related to disability in the middle and oldest age groups; long-term hypertension was related to disability in the middle age group. Both long-term and current measures of diabetes in the oldest age group and long-term measure of cigarette use in the middle age group of women were also related to disability. Age-specific analyses among men indicated that the only statistically significant risk factor was long-term hypertension in the youngest age group. Cholesterol was not related to disability. Results suggest that certain cardiovascular risk factors should be considered in efforts to understand further the development of disability.

Age Factors↗
PubMed1985

Trends in health in the United States.

The National Center for Health Statistics (NCHS) conducts a variety of surveys designed to provide cross-sectional estimates of the prevalence of various factors measuring the health of Americans. When these cross-sectional estimates are put together and plotted over time, they provide a picture of the trends in the health of the population. However, differences in methodology, completeness of coverage, validity and reliability of the information, and changing attitudes about health and illness influence these trend patterns and sometimes make them difficult to interpret. Six different measures of the health of Americans discussed include trends in life expectancy, which is related to the total mortality rate; trends in mortality by specific causes; trends in morbidity or the prevalence of various illnesses, including both acute and chronic conditions; trends in the estimates of various types of disabilities and impairments in the population; trends in expenditures for medical care and services; and finally, some assessments of trends in several risk factors and physiological characteristics obtained by direct measurements of individuals.

Accidents, Traffic↗
PubMed1985

Epidemiology of obesity in relation to health hazards.

Examination of total mortality in relation to Metropolitan Relative Weight among 2223 men followed for 30 years in the Framingham Heart Study shows that the duration of follow-up influences the nature of the relationship. During the first 6 years, among nonsmokers, mortality and weight had an inverse relation, but as time goes on the relation becomes U-shaped with a minimum mortality at a relative weight of 100% to 109%. Similar relations are found among men who smoke. Time trends in national mortality rates, however, do not show a direct relation to national trends in mean body mass index. Caution is necessary in relating to the effects of changes in obesity levels in populations to indices of health and longevity.

Adult↗
PubMed1985

The Framingham Study: sample selection, follow-up, and methods of analyses.

The Framingham Heart Study, begun in 1948, had a cohort of 5,209 individuals who have been followed for 35 years. The selection of this population and the success in following it through biennial clinical examinations and indirect surveillance for deaths and hospitalizations are described. The major techniques used in analysis of the Framingham data are identified.

Adult↗
PubMed1984

The magnitude and nature of the decrease in coronary heart disease mortality rate.

The age-adjusted cardiovascular mortality rate has fallen by 40% in the United States over the last 30 years, primarily since the late 1960s. Although cardiovascular disease is still the leading cause of death in this country, the rate of deaths from cardiovascular disease have dropped to below 50%, and the rate continues to decrease. In actual numbers, it has been estimated that as many as 300,000 people between the ages of 35 and 65 years would have died from coronary heart disease between 1968 and 1978 if the mortality rate had remained unchanged. The extent of the decline varies with different areas of the country and most dramatically affects the black population. Between 1970 and 1980, life expectancy increased by 2.7 years for white men, 2.5 years for white women, 3.7 years for black men, and 4.0 years for black women. Attempts to analyze the decline in mortality must take 2 features of mortality into consideration: incidence and case fatality, which reflect changes in primary prevention factors and in treatment methods, respectively. However, data on cardiovascular disease conflict and are difficult to interpret. Many methods of estimating the potential effect of altering or eliminating potential risk factors such as smoking, hypertension and cholesterol have been explored, with encouraging results.

Adult↗
PubMed1984

Coronary heart disease mortality rates in United States blacks, 1968-1978: interstate variation.

It has been shown that, among white males and females, recent declines in mortality from coronary heart disease (CHD) have not been uniform by region or state. Some clustering has emerged. To describe trends for the black population by states, we compared CHD death rates for persons aged 35 to 74 years for the years 1968-1972 in combination with rates for 1978. Reported mortality from 34 states with reasonably large black populations was described. Not all of the recent geographic shifts for white CHD mortality rates were apparent for blacks. Yet there were similarities, chief of which were the slower decline, and therefore worsening, of relative CHD mortality in certain states in Appalachia.

Adult↗
PubMed1984

Family resemblances in height and relative weight in the Framingham Heart Study.

The correlations of both height and relative weight (the Quetelet Index: wt/ht2) were studied amongst adult relatives in the Framingham Heart Study. The parental generation was first examined starting in 1949 when they were aged 30-62 years. The offspring (and their spouses) were examined beginning in 1971 when they were aged 20-49 years. Thus, it was possible to compare adult levels of body size in two generations. For height there are correlations between relatives that suggest large genetic variation for adult body height. For relative weight as measured by Quetelet's Index, the associations between relatives show a pattern that is more difficult to interpret and gives little support for sizable contributions of genetic differences to the population variation in relative weight. Although there is little evidence for large genetic variation for obesity, there is marked resemblance for obesity among first-degree relatives. This fact may be used to advance the family-based approach to screening, identification and intervention on the cardiovascular complications of obesity.

Adult↗
PubMed1983

Does change in blood pressure predict heart disease?

Whether a change in blood pressure is related to the occurrence of cardiovascular disease, independent of blood pressure level, was investigated using data collected in the Framingham heart study on 5209 subjects. The follow up period of 26 years was divided into a first period of 12 years in which the blood pressure change was computed for each individual and a subsequent period of 14 years in which the risk of cardiovascular disease was determined. Blood pressure change was positively related to risk of cardiovascular disease. This association remained when blood pressure level at the start of the study was taken into account but disappeared when the level attained after the first 12 years was taken into consideration. For the clinician this suggests that the decision to treat high blood pressure is best guided by the actual level of pressure and not by its long term trend in the past.

Adult↗