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Biomedical subjects

M Szklo

Publications and source records attributed to M Szklo.

At least 127 records · Page 7Linked to original sources
PubMed1981

Mortality after bereavement.

A nonconcurrent prospective study in Washington County, Maryland, identified 4032 (1204 male, 2828 female) white persons aged 18 years and over who were enumerated in a 1963 nonofficial census and became widowed between 1963 and 1974, and an equal number of married persons, each matched to a widowed person as to race, sex, year of birth and geography of residence. All were followed to 1975, the date of a second census. Mortality rates based on person-years at risk were virtually no different for female widowed than married, but significantly higher for male widowed than married, even after adjustment for a number of demographic, socioeconomic and behavioral variables. The male widowed in all age groups experienced higher mortality than the male married, the relative risk attaining statistical significance only in age groups 55--64 and 65--74 years, although the indicated relative risk was even higher in the younger age groups. There was little evidence of higher mortality in the first or second six-month intervals following bereavement than in subsequent years for either sex, but a suggestively higher mortality in year 2 for female widowed under age 65 years.

Adolescent↗
PubMed1981

Factors associated with mortality after widowhood.

A non-concurrent prospective study in Washington County, Maryland identified 4,032 (1,204 male, 2,828 female) White persons aged 18 and over who were enumerated in a 1963 non-official census and who became widowed between 1963 and 1974, and an equal number of married persons, each matched to a widowed as to race, sex, year of birth and geography of residence. All were followed to 1975, the date of a second census. Mortality rates based on person-years at risk were about the same for widowed as for married females, but significantly higher for male widowed than male married, even after adjustment for a number of demographic, socioeconomic, and behavioral variables. Mortality rates among widowed males who remarried were very much lower than among those who did not remarry, but no significant difference was observable among widowed females who did nor did not remarry. Multiple regression analysis also showed that, for both sexes and independently of other factors, moving into a nursing home or other chronic care facility was associated with higher mortality than any other residential change or no change, and living alone was associated with higher mortality than living with someone else in the household.

Adult↗
PubMed1979

Additional data favoring use of anticoagulant therapy in myocardial infarction. A population-based study.

A community-wide study was conducted in metropolitan Baltimore in which the survival of 1,307 patients with acute myocardial infarction was examined according to use of anticoagulants. The adjusted in-hospital case-fatality rate was lower for patients receiving anticoagulants (18%) than for those not receiving this therapy (31%). This difference persisted in each period examined in the study (1966 and 1967 or 1971) and was found in 17 of 20 participating hospitals. For hospital survivors followed up for as long as ten years, a better survival was again found for those treated with anticoagulants in the acute phase compared with those not treated.

Anticoagulants↗
PubMed1979

Acute myocardial infarction. Prognosis complicated by ventricular fibrillation or cardiac arrest.

A community-wide study was conducted in metropolitan Baltimore in which the prognosis of 330 patients hospitalized with an acute myocardial infarction (MI) complicated by ventricular fibrillation or cardiac arrest (VFib/CA) was compared with that of 1,071 patients hospitalized with acute MI not complicated by VFib/CA. As expected, the in-hospital case-fatality rate among patients with MI complicated by VFib/CA was significantly higher than that in patients without VFib/CA. However, for patients discharged alive from the hospital, no significant differences in long-term survival were found between patients with MI with or without VFib/CA. These results suggest that attempts at preventing subsequent mortality should be diligently pursued in patients with MI who are discharged alive from the hospital regardless of the occurrence of VFib/CA in the acute phase.

Follow-Up Studies↗
PubMed1979

The prognosis of anterior myocardial infarction revisited: a community-wide study.

A study was carried out in metropolitan Baltimore in which the short- and long-term prognosis of 655 patients with anterior myocardial infarction (MI) was compared with that of 520 patients with inferior/posterior MI. The study was performed on a community-wide basis in two time periods before the clinical introduction and widespread use of beta-blockade therapy. After simultaneous adjustment for several socio-demographic and clinical variables, the in-hospital case fatality rate was greater for patients with anterior (27.5%) than for those with inferior/posterior MI (22.9%) (p less than 0.05). Similarly, for those discharged alive from the hospital and followed up for as long as 10 years, patients with infarction of the anterior wall had a significantly poorer long-term survival than that of patients with infarction of the inferior/posterior wall (p less than 0.05). These results suggest that closer surveillance should be directed at patients with anterior myocardial infarction, both during the acute phase and after hospital discharge.

Follow-Up Studies↗
PubMed1979

Risk factors for brain tumors in children.

An exploratory case-control study was conducted in 15 hospitals in the Baltimore, MD, SMSA of possible etiologic factors associated with brain tumors in children. Eighty-four children with brain tumors were compared to normal children and to children with other malignancies. Parents of these children were interviewed about a variety of possible etiologic factors. The findings included: 1) children with brain tumors as well as children with other cancers had a greater tendency than normal children to have been first births and to have had higher birth weights; 2) more children with brain tumors had a sibling with epilepsy or seizures than did normal children, and several of the mothers of children with brain tumors had themselves had epilepsy or a stroke at a relatively young age; 3) there were no significant differences between the groups with regard to several maternal characteristics, including smoking during pregnancy and prior radiation exposure; 4) more children with brain tumors and children with other cancers were found to have had exposures to insecticides than had normal children; 5) fewer children with brain tumors or with other cancers were reported to have had tonsillectomies than normal children; and 6) more of the children with brain tumors as well as the children with other malignancies were reported to have been exposed to farm animals and to sick pets. This exploratory study is one of the first case-control studies of the epidemiology of brain tumors in children, and the results suggest directions for future epidemiologic studies in this relatively uncharted field.

Adolescent↗
PubMed1979

Time trends in prognosis of patients with myocardial infarction: a population-based study.

A population-based study was conducted in metropolitan Baltimore, in which the prognosis of 504 patients hospitalized with acute myocardial infarction (MI) from July 1966 through June 1967 was compared with that of 803 patients hospitalized from January through December 1971. For patients admitted to coronary care units (CCUs), the in-hospital case-fatality rate (CFR) in 1971 (20%) was found to be significantly lower than that in 1966/67 (27.5%) (p less than .025), after simultaneous adjustment for 16 variables which may affect prognosis. No such significant difference was detected for patients not admitted to CCUs when the two time periods were compared. As a result of these time trends, CFRs were not significantly different between CCU and non-CCU patients in 1966/67, but in 1971 a significant advantage was shown for CCU patients (p less than .005). These results suggest that effectiveness of CCUs in prevention of in-hospital deaths increased between 1966/67 and 1971. For hospital survivors, regardless of admission to a CCU, no significant differences in long-term prognosis were found between patients discharged in 1971 and those discharged in 1966/67. This finding may reflect the lack of major therapeutic advances between the two study periods, aimed at reducing the progression of coronary atherosclerosis and/or the extent of the infarcted area.

Acute Disease↗
PubMed1979

Length of time between hospital admission and ventricular fibrillation or cardiac arrest complicating acute myocardial infarction: effect on prognosis.

We performed a community-wide study in metropolitan Baltimore to examine the prognostic role of length of time between hospital admission and ventricular fibrillation or cardiac arrest (VFib/CA) complicating acute myocardial infarction (MI). Risk of developing VFib/CA was particularly marked in the first few hours after admission to the hospital. We compared 128 patients experiencing VFib/CA within 48 hours of admission and 80 patients developing these complications after more than 48 hours. Patients with "early" VFib/CA exhibited a lower in-hospital case-fatality rate than those with "late" VBib/CA (67% versus 88%; p less than .01). Likewise, of patients discharged alive from the hospital and followed for as long as six years a greater proportion of the 38 with histories of "early" VFib/CA survived than of the 11 who had experienced "late" VFib/CA during hospital admission (.05 less than p less than .10). These results suggest that whereas "early" VFib/CA may reflect transitory myocardial electrical instability, "late" VFib/CA may indicate chronic instability and thus imply a poor prognosis.

Heart Arrest↗
PubMed1978

The changing survivorship of white and black children with leukemia.

A study was conducted in metropolitan Baltimore to examine changes in survival of white and black children with acute leukemia from 1960 through 1975. Two-hundred eighty-seven cases were identified, of which 77% were acute lymphocytic leukemia (ALL). Eighty-three percent of all cases occurred in white children. In white children with ALL, two-year survival rates increased from 32% in 1960--64 to 47% in 1965--69, and to 79% in 1970--75 (p less than .005). In the small sample of black children with ALL, two-year survival rates increased from 25% in 1960--64 to 59% in 1965--69 (p less than .01), with no further increase in 1970--75. For acute nonlymphocytic leukemia (ANLL), survivorship was analyzed in white children, among whom one-year survival rates increased from 42% in 1965--69 to 71% in 1970--75 (p less than .005). The increasingly better survival over time of white children with acute leukemia probably reflects the increasing efficacy of new therapeutic approaches.

Acute Disease↗
PubMed1978

Survival of patients with nontransmural myocardial infarction: a population-based study.

A population-based study was conducted in metropolitan Baltimore in which the short- and long-term prognosis of 283 patients with nontransmural myocardial infarction was compared with that of 953 patients with transmural infraction. After simultaneous adjustment for several variables, the in-hospital case fatality rate was greater for patients with transmural (30.1 percent) than with nontransmural (18.3 percent) infarction (P less than 0.01). However, for patients discharged alive from the hospital and followed up for as long as 10 years, no significant differences in survival were found between the groups with transmural and nontransmural infarction. A multiple adjustment procedure yield 3 year case fatality rates of 27.1 percent and 28.3 percent, respectively, for patients with transmural and nontransmural myocardial infarction surviving the acute phase. These results suggest that the long-term prognosis of patients with nontransmural infarction is as guarded as that of patients with transmural infarction and that attempts to prevent subsequent mortality should be diligently pursued in both groups of patients.

Aged↗
PubMed1978

Increased risk of brain tumors in children exposed to barbiturates.

The possible etiologic role of barbiturates in the development of brain tumors in children was examined. Interviews were conducted with mothers of children with brain tumors and results compared with those from interviews with mothers of normal children and mothers of children with other cancers. Mothers of children with brain tumors more frequently reported having used barbiturates during their pregnancy with the index child than did mothers of normal children or mothers of children with other cancers. In addition, more children with brain tumors were reported to have used barbiturates than were normal children or children with other malignant diseases, with most of such uses appearing to be unrelated to symptoms resulting from the brain tumor itself. The results suggested that barbiturates may play an etiologic role, and it is estimated that as many as 8% of brain tumors in children may be attributable to use of barbiturates either by the child or prenatally by the mother.

Adolescent↗
PubMed1976

Psychosocial factors and the risk of myocardial infarctions in white women.

The relationship of risk of myocardial infarction (tmi) to psychosocial factors was studied retrospectively in 107 white women hospitalized with first MI's and in 218 controls hospitalized for other diseases. Meical records were abstracted and the women were interviewed. Psychosocial factors associated with MI were educational discrepancy, in which the patient ha less education than her husband, householo crowding and late birth order. Eoucational discrepancy was independently associated with MI, but household crowding and birth order seemed to act as risk factors for MI only when certain biological risk factors were also present. The findings indicate that certain psychosocial factors related to risk of MI in white males are also risk factors for MI in white females especially in association with biologic risk factors. Thus the effects of certain psychosocial factors may assume clinical importance only when interacting with an underlying disease state as indicated by the presence of major biologic risk factors.

Adult↗