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Biomedical subjects

R E Harris

Publications and source records attributed to R E Harris.

At least 91 records · Page 5Linked to original sources
PubMed1989

Population screening for plasma cholesterol: community-based results from Miami.

Plasma cholesterol was measured in 7,338 participants of a cholesterol screening in Miami, Florida. They were typically health conscious as evidenced by the low prevalence of current cigarette smoking (16%). However, more than 30% of males and 49% of females over age 50 had cholesterol levels in excess of 240 mg/dl, placing them at moderate to high risk for coronary artery disease. Results revealed a dose response relationship between cigarette smoking and cholesterol in men of all age groups and in women of premenopausal age; whereas the average cholesterol was similar in exsmokers and never smokers. Risk analysis revealed a strong positive association between cholesterol and the period prevalence of myocardial infarction in men and women. Male and female patients with newly diagnosed hypercholesterolemia reduced their cholesterol an average of 13 and 10 mg/dl, respectively, under care of a physician. These results indicate that cholesterol screening coupled with physician follow-up and treatment can lower cholesterol and its attendant risk of cardiovascular disease.

Adolescent↗
PubMed1988

Comparative epidemiology of cancer between the United States and Italy.

Available statistics on smoking, alcohol, food supply, reproductive history, and other lifestyle habits from the U.S. and Italy were compared and related to mortality rates of common neoplasms over the period 1955 to 1980. Per capita cigarette consumption has declined in the U.S. since the early 1960s but continues to rise in Italy, chiefly due to the recent increase in cigarette smoking among Italian women. Alcohol consumption has increased in both countries, being persistently about 40% higher in Italy. Changes were relatively limited in the American diet, but substantial for the Italian one which had particularly marked increases in meat, milk, and fat consumption. Fertility rates have declined in both countries but more sharply in the U.S. These lifestyle changes were reflected by distinctly divergent trends in cancer mortality rates between the two countries. In Italian males, mortality rates of urinary bladder cancer and alcohol-related neoplasms of the aerodigestive tract (oral cavity, larynx, and esophagus) increased in a similar manner and were persistently elevated relative to American males. Similarly, Italian lung cancer rates, while starting from lower values, rose steadily to overtake American rates in the younger and middle age groups of both sexes, and neoplasms of the intestines, breast, and ovary, starting from considerably lower values, tended to approach the American rates over the 25-year period considered. Within Italy, mortality rates of most common neoplasms were substantially elevated in the North of the country relative to the South, thereby paralleling the distinct North to South gradient in socioeconomics, diet, and affluent lifestyle which exists in the country. In our opinion, most of these trends are real, and their explanation should be sought, partly or largely, in the changes in tobacco and alcohol use, and the reproductive and dietary patterns described. The evidence presented underlies the importance of this kind of exercise to formulate and test etiological hypotheses of human diseases, which may be overlooked in studies based on populations with more homogeneous lifestyle habits or environmental exposures.

Alcohol Drinking↗
PubMed1988

Cigarette smoking, alcohol consumption and primary liver cancer: a case-control study in the USA.

Cigarette smoking and alcohol consumption were examined as potential risk factors in a case-control study of primary liver cancer (PLC). A total of 165 PLC cases and 465 matched controls from several US hospitals were studied. A weak but statistically significant (p less than 0.05) dose-response relationship was observed between alcohol consumption and PLC in elderly females independent of other major risk factors (adjusted OR = 1.87 and 3.48 for 1-2 and greater than 3 drinks per day, respectively) and a similar trend was evident in elderly males. The risk for PLC was also elevated in elderly females who were current cigarette smokers (adjusted OR = 3.30). Our results suggest that alcohol consumption and cigarette smoking may have minor age- and sex-specific effects on the development of PLC, and underscore the need for further investigations to elucidate major PLC risk factors in US populations.

Adult↗
PubMed1988

Breast cancer and alcohol consumption. A study in weak associations.

A total of 1467 cases of women with breast cancer and 10,178 sex- and age-matched hospital controls were examined for alcohol consumption and other potential risk factors. Effects of risk factors were assessed by odds ratios, and adjustment was made for confounding variables by using stratified analyses and logistic regression. Several factors were found to influence alcohol consumption, including age, religion, education, occupation, marital status, body mass, and cigarette smoking. Lean women (Quetelet index, less than 22) had elevated unadjusted odds ratios for breast cancer of 2.10, 1.71, and 1.41 associated with consuming less than 5, 5 to 15, and more than 15 g of alcohol per day, respectively. However, this pattern is not consistent with a dose response, and adjustment for a risk profile of confounding factors, including education and occupation (which are strong correlates of age at first pregnancy and parity), reduced these estimates to 1.40, 1.24, and 0.87, none of which differs significantly from 1.0. Among all subgroups, the odds ratios adjusted for pertinent confounders and interactions fluctuated randomly about 0.94 and showed no consistent trend with increasing alcohol consumption. While these results do not entirely rule out a weak association between breast cancer and alcohol in certain subgroups, neither do they provide compelling evidence that alcohol has a role in the genesis of this malignancy.

Adult↗
PubMed1988

Case-control study of prostate cancer and socioeconomic factors.

A total of 1,162 prostate cancer cases and 3,124 age-matched hospital controls from several U.S. hospitals were studied to identify associations between prostate cancer and life-style variables. Among white males, college education, professional occupation, and non-Jewish ethnicity were weakly associated with the risk of prostate cancer (ORs = 1.5, 1.8, and 1.3, respectively, P less than 0.01). These relationships retained statistical significance after adjustment for age, marital status, body mass, cigarette smoking, alcohol consumption, and physical activity in multiple logistic regression models. Among black males, similar, though nonsignificant, risk elevations were observed for education and occupation. Weak positive effects of borderline statistical significance were observed for high body mass, low physical exercise, and high serum cholesterol (in elderly males only), and a significant reduction in risk was noted for never married black males. Cigarette smoking and alcohol consumption were not related to the risk of prostate cancer.

Adult↗
PubMed1988

Studies of breast cancer and alcohol consumption.

Alcohol consumption as a potential risk factor for breast cancer was examined in a case-control study of 1,467 female breast cancer patients and 10,178 hospital controls. Lean females (Quetelet index less than 22) had elevated unadjusted odds ratios for breast cancer of 2.1, 1.7, and 1.4, associated with consuming less than 5, 5-15, and greater than 15 g of alcohol per day, respectively. However, this pattern is not consistent with a dose-response, and adjustment for a risk profile of confounding factors, including education and occupation (which are strong correlates of age at first pregnancy and parity), reduced these estimates to 1.4, 1.2, and 0.9; none of which differs significantly from 1.0. Among all subgroups, the odds ratios adjusted for pertinent confounders and interactions fluctuated randomly by about 0.9 and showed no consistent trend with increased alcohol consumption. In a second investigation, proportional breast cancer rates were estimated for female veterans diagnosed in Veterans Administration Hospitals during 1970-1982 using 1973-1977 rates for the general population as the standard of comparison. In the VA cohort of females, which had an approximate twofold higher prevalence of alcohol abuse and chronic cigarette smoking, the proportional rates of known alcohol and tobacco-related malignancies were significantly elevated but the rates of breast cancer were not. The standardized proportional morbidity rates of breast cancer for white, black, and all VA females were 0.92, 0.85, and 0.91, respectively. Although these results do not rule out weak associations between breast cancer and alcohol in certain subgroups, neither do they provide any compelling evidence that alcohol has a role in the genesis of this malignancy.

Alcohol Drinking↗
PubMed1988

Severe illness in older patients: the association between depressive disorders and functional dependency during the recovery phase.

An association between depression and physical dependency arising from a recent illness has been generally accepted. To clarify this relationship over time, 30 medical rehabilitation patients aged 54 to 94 years were assessed 1 week after admission and at discharge to quantify symptoms of depression, physical dependency, and cognitive functioning using the Hamilton Depression Scale (HAM-D), the Geriatric Depression Scale (GDS), the Barthel Index for physical function, and the Mini-Mental State Examination (MMSE). Significant depressive symptomatology was found by HAM-D in 25 patients on admission and 14 on discharge. No significant associations were present between either admission or discharge depression scores and all other variables. The HAM-D change score was significantly correlated with the Barthel change score (r = 0.57, P less than 0.001) and with the MMSE change score (r = 0.48, P = 0.01). All patients whose mood improved also improved in physical functioning, whereas 75% of those whose mood did not improve failed to make headway in physical functioning. This implies that it is not the degree of physical incapacity but rather the failure to regain prior abilities which is strongly associated with persisting depression following a catastrophic illness. Furthermore, characteristics found commonly in the group whose mood did not improve included physicians' failure to diagnose and treat depression or a setback from a significant medical or surgical complication.

Aged↗
PubMed1988

Clinical variability of cyclosporine pharmacokinetics in adult and pediatric patients after renal, cardiac, hepatic, and bone-marrow transplants.

The most important limitation associated with the clinical use of cyclosporine is the narrow therapeutic range between its efficacy and toxicity. Effective treatment is further complicated by significant variation in intrapatient and interpatient pharmacokinetics of the drug. We describe a practical approach to pharmacokinetic analysis that does not interfere with the cyclosporine dosage regimen or with clinical management of the patient. To optimize therapy, we individualized patient management by using noncompartmental pharmacokinetic analysis. Mean residence time (MRT) and volume of distribution at steady-state were calculated from data on concentration vs time after dose. We applied this approach to 24 kidney, 12 heart, 8 bone-marrow, 7 liver, and 5 pancreas transplants. Individualized requirements for cyclosporine dose and dosage interval can be predicted from these parameters. MRT is the most useful pharmacokinetic parameter, because it allows prediction of the optimal dosage interval.

Adult↗
PubMed1987

The seasonal risk of pediatric/juvenile acute lymphocytic leukemia in the United States.

Acute lymphocytic leukemia (ALL) occurring in pediatric and juvenile patients of nine U.S.A. locations during 1973 through 1980 was investigated by epidemiologic methodology. Time series periodic regression analysis of the monthly cumulative risk for ages 0-19 years revealed evidence of trimodal periodicity at seven of the nine locations tested. Combined analyses revealed a significant effect of latitude in causing asynchrony of the trimodal patterns observed. The average risk maxima occurred in April, August, and December for U.S.A. locations with latitude above 40 degrees (Seattle, Nebraska, Iowa, Detroit, and Connecticut), and in February, July, and October for other locations (San Francisco, Utah, New Mexico, and Atlanta). Because periodic regression analysis is a complex method, independent validation tests were performed to supplement the original results. Here, the best symmetric trimodal sine curve model of each location was utilized to predict the average pattern among the remaining locations of similar latitude. These validation tests supported the existence of similar trimodal patterns for all of the southern locations, and all of the northern locations except Connecticut. The observed peaks in monthly ALL risk coincide with seasonal elevations in the rates of allergenic and infectious diseases, elements of which are capable of promoting lymphocytic proliferation and transformation. Annual disease rates were significantly lower in populations with a high proportion of Blacks or American Indians compared to predominantly Caucasian populations. The possibility that seasonal factors (environmental allergens and/or infectious agents) promote leukomogenesis via indirect mechanisms is briefly discussed.

Adolescent↗
PubMed1986

Megakaryoblastic leukemia in an infant. Establishment of a megakaryocytic tumor cell line in athymic nude mice.

A 17-month-old infant with clinical and pathologic features of acute megakaryoblastic leukemia and myelofibrosis developed soft tissue metastases. Tissue from an orbital metastasis was biopsied and transplanted into a nude mouse. Histologically the tumor was composed of pleomorphic cells with single convoluted nuclei or multilobed nuclei and prominent granular cytoplasm and had an alveolar histologic pattern in some areas. The ultrastructural features of the tumor cells include multilobed nuclei with prominent nucleoli and cytoplasmic granules with the characteristics of alpha-granules. The tumor has been successfully passaged over a 1-year interval and appears to be a stable megakaryoblastic tumor cell line (CHRF-288). Cells from the tumor line are reactive for factor VIII related antigen and also have GpIIb IIIa complex antigen on the plasma membrane surface. This tumor line may be a useful system for investigation of megakaryocytic functions including the production and regulation of the various factors they produce.

Animals↗
PubMed1986

Prognostic value of peritoneal washings in patients with malignant mixed müllerian tumors of the uterus.

Peritoneal washings from 36 women with all pathologic stages of mixed müllerian tumors of the uterus (27 homologous stroma, nine heterologous stroma) were reviewed in a blinded retrospective fashion for the presence and type of malignant cells collected. Malignant tumor cells were demonstrated in the washings of 16 patients; 13 contained adenocarcinoma only, two contained adenocarcinoma and sarcoma, and one contained sarcoma cells only. Cox's logistic regression analysis showed that cytologic examination of peritoneal washings when combined with pathologic staging provides a statistically significant discriminant of disease-free survival. Patients with a favorable prognosis (pathologic Stage I and peritoneal washings free of malignancy) had sevenfold increased disease-free survival compared with survival of the patients with an unfavorable prognosis (pathologic Stages II, III, or IV or malignant cells present in peritoneal washings). Three of the 18 patients with pathologic Stage I disease manifested malignant tumor cells in the peritoneal washings and all three patients died of disease in less than 1 year. The presence of malignant cells in peritoneal washings in patients with mixed müllerian tumor apparently limited to the uterus suggests a clinical course that is similar to that of those with more advanced disease.

Adenocarcinoma↗
PubMed1986

Spinal cord infarction following intraaortic balloon support.

Infarction of the lumbar and sacral spinal cord was demonstrated at autopsy of a 72-year-old man in whom acute paraplegia developed following coronary artery bypass grafting and atrial septal defect repair with intraoperative insertion of an intraaortic balloon. Autopsy findings showed that infarcts of the spinal cord and other key organs were caused by critical occlusion of small arterioles by cholesterol emboli. These emboli apparently arose as a result of the fragmentation of atheromatous plaques within the aorta during use of the intraaortic balloon pump with subsequent embolization and occlusion of small blood vessels.

Aged↗
PubMed1986

Relationship between serum lactate and ionized calcium in open-heart surgery.

We studied 16 patients undergoing open-heart surgery and heart-lung bypass, to examine the relationship between ionized calcium and lactate. Blood was sampled at successive stages of the operation for measurement of ionized and total calcium, lactate, blood gases, pH, hematocrit, and other constituents. We found that correlations between ionized calcium and lactate were positive and statistically significant (p less than 0.05), both among and within patients. The linear regression of ionized calcium on lactate remained highly significant (p less than 0.0001) after adjustment for variability among patients and across operative stages as well as after correction for pH and hemodilution. The significant regressions between calcium and lactate, both before and after administration of calcium, indicate a relationship for calcium and lactate in patients undergoing open-heart surgery.

Blood↗