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Biomedical subjects

R M Lauer

Publications and source records attributed to R M Lauer.

At least 73 records · Page 4Linked to original sources
PubMed1986

The relations between type A behavior, clinically relevant behavior, academic achievement, and IQ in children.

The relation of Type A behavior to IQ, academic achievement, and several clinically relevant dimensions of behavior in children was assessed in 873 fourth, fifth, and sixth graders by means of the Matthews Youth Test for Health (MYTH), the Cognitive Abilities Test (CAT), the Iowa Tests of Basic Skills (ITED), and the teachers' form of the Missouri Children's Behavior Checklist (MCBC-T). The MYTH and its competitiveness and impatience-aggression subscales were found to be differentially related to academic achievement and to account for a small but significant portion of the variance in achievement not accounted for by IQ. The subscales of the MYTH were found to be highly correlated with several clinically familiar dimensions of children's behavior. The significance of these findings for the construct validity of the MYTH is discussed.

Achievement↗
PubMed1986

Tracking of blood pressure during childhood: the Muscatine Study.

Four thousand three hundred and thirteen children beginning at five to fourteen years of age have been examined on three to six occasions in Muscatine, Iowa on alternate years. To compare blood pressures throughout the period of observation each value was expressed as a percentile rank. For each subject the average percentile rank (level), the trend in rank and the variability over time were calculated. Values for height, weight, relative weight and triceps skinfold thickness measurements were expressed in the same fashion. The relationship between average rank of blood pressure and average rank of body size as well as between trend of blood pressure and trend of body size percentiles were significant (p less than .05). These observations indicate the importance of relative rate of growth in the establishment of the rank order of blood pressure.

Adolescent↗
PubMed1986

Hemodynamics in childhood hypertension.

Children with elevated systolic blood pressure have a wide range of cardiac output. We investigated the mechanisms regulating resting and exercise blood pressure in 264 children who were selected from the low, middle, and upper quintile of the distribution of blood pressure of an entire school population. We identified patterns of response to exercise that correlated both with resting cardiac output and resting blood pressure. During isometric exercise, systolic blood pressure adjusted for age and body size increased in all groups. The low group mean pressure remained significantly lower than the high group's pressures throughout the entire exercise period. Body size adjusted group systolic and diastolic blood pressure level differences existed during dynamic exercise. The product of the systolic blood pressure times the heart rate in the high blood pressure group was significantly higher throughout dynamic exercise than in the other two groups. Elevated resting resistance was correlated with elevated resistance during isometric exercise and elevated diastolic blood pressure during dynamic exercise. Cardiac index had a significant negative correlation to age (r = -0.58) at all levels of blood pressure. This observation, in children, lends some support to the concept of evolution from a hyperkinetic circulation in early childhood to a circulation with lower cardiac output and more elevated systemic vascular resistance at an older age.

Age Factors↗
PubMed1986

Life insurance for children with cardiovascular disease.

To determine the life insurability of young people with cardiovascular disease, we sent questionnaires to 99 life insurance companies concerning 18 congenital defects, rheumatic heart disease, and four dysrhythmias. We received 50 responses (50%) from companies whose sales make up 41% of the life insurance market. The concensus of insurability for the defects listed was: standard rates--mild pulmonic stenosis, rheumatic fever without carditis, mitral valve prolapse without regugitation, and the following postoperative lesions: patent ductus arteriosus, atrial septal defect, pulmonic stenosis, ventricular septal defect; uninsurable--most unoperated lesions, postoperative lesions with complex dysrrhythmias, severe aortic insufficiency, idiopathic hypertrophic subaortic stenosis, Ebstein's anomaly, truncus arteriosus, tricuspid atresia; insurable at increased rates--most other defects, including dextrotransposition of the great vessels, postoperative aortic stenosis, mild aortic insufficiency, postoperative coarctation of aorta, postoperative tetralogy of Fallot, and small ventricular septal defect. We conclude that life insurance is available to many children with cardiovascular disease, including most postoperative patients. Whether the increased rates requested for some defects are prohibitive is a matter to be decided by each family.

Arrhythmias, Cardiac↗
PubMed1986

Lipoproteins in the progeny of young men with coronary artery disease: children with increased risk.

The authors studied 173 progeny from 63 families in which the father had angiographically diagnosed coronary artery disease by 50 years of age. To assess the nature of the coronary risk factors in these families, we measured their height and weight to calculate Quetelet index (wt/ht2), BP, fasting plasma cholesterol, triglyceride, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were measured in the affected fathers, their wives, and their progeny. These values were compared with age- and sex-specific values from the Lipid Research Clinic data. Sixty-five percent of the affected fathers and 51% of the progeny had elevated triglyceride, elevated low-density lipoprotein cholesterol, diminished high-density lipoprotein cholesterol, or combinations thereof. The distribution of the lipids and lipoproteins in the children bore a close resemblance to those observed in the affected fathers. A significant number of the mothers had diminished high-density lipoprotein cholesterol, which was attributed to their obesity. Screening the progeny of young coronary artery disease patients is therefore highly productive in identifying young people at excessive risk for future coronary artery disease. Early identification of this young high-risk population offers an opportunity for early initiation of preventive measures.

Adolescent↗
PubMed1985

Social influences and constraints on the initiation and cessation of adolescent tobacco use.

This research examines the viability of a theoretical perspective which combines social bonding theory and differential association theory in explaining the initiation and cessation of adolescent tobacco use. Three-year panel data collected from seventh- to twelfth-grade adolescents were analyzed using differences in means tests and discriminant analysis. The findings indicate overall support for the theoretical model in discriminating between (1) initiators and stable nonsmokers and (2) cessators and stable smokers. However, there were some differences in the variables found to be important at each stage of adolescent smoking. Commitment to education, attachment to father and mother, and association with female smoking friends were the most effective discriminators for the initiation stage, while attachment to father, beliefs, and association with both male and female smoking friends were important for the cessation stage. Findings are also discussed for males and females and for junior and senior high-school adolescents.

Achievement↗
PubMed1985

Pacemaker management for acute onset of heart block in childhood.

Four children aged 2 to 15 years are described who had Stokes-Adams syndrome as the primary cardiac manifestation of complete heart block. All had mild, nonspecific antecedent symptoms without signs of congestive heart failure. Viral neutralizing antibody titers (coxsackievirus B1 and B2) rose significantly in two patients. Electrocardiography demonstrated complete heart block associated with one or more of the following: right bundle branch block, left anterior hemiblock, left bundle branch block, intraventricular conduction delay, and ventricular standstill. In addition, second-degree heart block was seen during the initial or resolving phases of illness. To prevent further life-threatening episodes of Stokes-Adams syndrome, temporary transvenous pacemakers were placed. Two patients with persisting complete heart block required permanent pacemakers. At last examination, the remaining two patients had sinus rhythm and normal conduction. Nonsurgical acquired complete heart block is unusual in childhood, and may be the only manifestation of myocarditis. Extreme bradycardia, which causes syncope, requires immediate temporary cardiac pacing; if the bradycardia persists, a permanent pacemaker should be implanted.

Acute Disease↗
PubMed1985

The newborn transitional circulation: a two-dimensional Doppler echocardiographic study.

To characterize changes in circulation after birth, 11 normal full-term infants were examined with two-dimensional and pulsed Doppler echocardiography. The initial examination was performed within 10 hours after delivery and serially for 3 days. Retrograde diastolic pulmonary artery velocities, which are evidence for a patent ductus arteriosus, were detected in 10 infants (91%) on day 1, in 2 (18%) on day 2 and in none on day 3. Retrograde systolic descending aortic velocities, which are evidence of flow from the aorta into the ductus arteriosus, were observed in 10 infants (91%) on day 1, 9 (81%) on day 2 and 7 (64%) on day 3. Persistence of the retrograde systolic velocity in the descending aorta in the absence of retrograde diastolic velocity in the pulmonary artery is consistent with physiologic ductal closure beginning near the pulmonary artery end of the ductus arteriosus. Localized turbulent retrograde systolic flow, proximal to the septal leaflet of the tricuspid valve and consistent with tricuspid insufficiency, was detected in six patients (55%) on day 1, in eight (73%) on day 2 and in seven (64%) on day 3. Thus, tricuspid insufficiency appears to be a frequent observation in healthy newborns. Normal Doppler velocities in the great arteries and across the tricuspid and mitral valves of newborns up to 3 days of age are presented. These normal measures of intracardiac flow velocities may be used for comparison to identify abnormal flow profiles in newborns with congenital heart defects.

Blood Circulation↗
PubMed1985

Assessing children's blood pressure--considerations of age and body size: the Muscatine Study.

Blood pressure was assessed in 4,207 children, aged 5 to 18 years, examined in the schools of Muscatine, Iowa during 1981. Overall, 69.9% of the age-sex-specific quintiles and height-sex-specific quintiles of systolic blood pressure were identical. In only 1.0% of children did these quintiles differ by more than one. Children whose blood pressure was in the highest quintile for both age and height were more obese than their peers. Those whose blood pressure was high for age but not for height were proportionately taller and heavier than their age peers. Children whose blood pressure was high for height but not for age were older, shorter, and lighter. Thus, having precocious levels of blood pressure for age during childhood is associated with excessive body weight or precocious height, whereas having high blood pressure for height but not for age is associated with being short for age. The latter suggests that age may be a factor independent of height and weight affecting blood pressure level in childhood. These relationships of body size and age to blood pressure must be considered when evaluating children's blood pressure levels in the clinical setting, and a technique for doing so is presented.

Adolescent↗
PubMed1984

Home environment questionnaire.

Psychometric and normative data are presented for two forms of the Home Environment Questionnaire (HEQ) that provide measures of 10 variables used to describe the psychosocial environments of children. One form, HEQ-2R, is suitable for use with families in which there are two parents; the other form, HEQ-1R, is for use with one-parent families. The HEQ scales are relatively independent and not significantly related to the age of the target child, and most of the scales are reasonably internally consistent. Previous research has found several of the HEQ scales to be significantly related to several dimensions of children's clinically important behavior.

Child↗
PubMed1984

Level, trend, and variability of blood pressure during childhood: the Muscatine study.

On alternate years from 1970 to 1981 blood pressure has been measured in school children living in Muscatine, Iowa. A total of 4313 children beginning at 5 to 14 years of age have been examined on three to six occasions. To compare blood pressures throughout the period of observation, each value was expressed as a percentile rank. For each subject the average percentile rank (level), the trend in rank, and the variability over time were calculated. Values for height, weight, relative weight, and triceps skinfold thickness were expressed in the same fashion. The relationship between average rank of blood pressure and average rank of body size as well as between trend of blood pressure and trend of body size percentiles were significant (p less than .05). These observations indicate the importance of relative rate of growth in the establishment of the rank order of blood pressure. Using the variables of level, trend, and variability, we identified groups of children who appear to be consistently tracking toward future hypertension: 233 (5.4%) children, whose systolic levels were in the upper quintile with either a flat or rising trend and low variability, and 280 (6.0%) children with systolic levels in the lower four quintiles with high trend and low variability. In addition there were 321 (7.4%) children whose mean systolic levels were in the upper quintile with high variability and who thus resemble adults with labile hypertension. There were similar numbers of children with diastolic pressures showing these features.

Adolescent↗
PubMed1983

Community differences in blood pressure levels and drinking water sodium.

In a study conducted in 1980-1981, the authors surveyed over 2000 school children in eight Iowa communities whose drinking water sodium levels varied from less than 10 to greater than 300 mg/liter. Children in grades 2-5 had four blood pressures, skinfold, height, weight, and heart rates measured while in school. The range of the difference between mean blood pressures by community was less than 4 mmHg for systolic and fourth phase diastolic. An association between blood pressure and water sodium level was not demonstrated before or after adjustment for covariates. In a subsample of over 200 households in four communities, the authors examined the relationship of blood pressures in adults to water sodium level. Blood pressure means for adults by community varied less than 4 mmHg for systolic and diastolic measurements. This variance was not explained by sodium level in the drinking water. These surveys do not substantiate previous reports of a positive association between drinking water sodium levels and blood pressure levels.

Adult↗
PubMed1982

Spontaneous closure of a coronary artery fistula in childhood.

An infant with a symptomatic coronary artery fistula, documented by angiography, is presented. By age 5 years, clinical evidence of the fistula was no longer present. Repeat cardiac catheterization confirmed spontaneous closure of the coronary artery fistula. More information regarding the natural history of a coronary artery fistula is required before an elective surgical approach can be recommended in all asymptomatic children.

Cardiac Catheterization↗
PubMed1982

The Muscatine Cholesterol Family Study: familial aggregation of blood lipids and relationship of lipid levels to age, sex and hormone use.

The Muscatine Cholesterol Family Study includes data on first, second and third-degree relatives of school children who have the following cholesterol levels: above the 95th percentile in two consecutive school screens, N = 53; below the 5th percentile twice, N = 45; and a random sample between the 5th and 95th percentiles twice, N = 44. For males and females not taking estrogen the relationship of cholesterol to age was the same in high, middle, and low groups, although the overall level differed. For females taking estrogen, cholesterol levels rose more quickly with age in the high group as compared to the middle and low groups. The triglyceride levels of females taking estrogen is higher at younger ages and shows no significant change with increasing age. Among first degree relatives, the cholesterol correlations are between 0.25 and 0.30. Correlations in relatives of the middle group probands are higher than those in relatives of high or low group probands, but not significantly so. Correction for ascertainment increases the correlations in the high and low groups. Among second degree relatives cholesterol correlations in all three groups are approximately 0.20. There is negligible cholesterol correlation between spouses in the high and low groups, while the middle group spouse correlation is significantly greater than zero. Categorical analysis suggests the effect of the proband's cholesterol level is seen most upon the cholesterol level of parents, with siblings and second-degree relatives being less similarly affected.

Adolescent↗
PubMed1982

The Muscatine Cholesterol Family Study: distribution of cholesterol levels within families of probands with high, low and middle cholesterol levels.

The Muscatine Cholesterol Family Study includes the relatives of three groups of schoolchildren: those with cholesterol levels above the 95th percentiles in two consecutive school screens, those with cholesterol levels below the 5th percentile twice, and random sample of those with cholesterol levels between the 5th and 95th percentiles twice. This paper examines the cholesterol distribution within and among these families for evidence of major gene effects. Three screening techniques are used: admixture analysis using maximum likelihood, comparison of within-sibship variances among groups, and regression of within-sibships variance on within-sibship mean. The results of the three techniques are consistent and indicate the existence of a major gene in a subset of the families with a proband above the the 95th percentile, but not in the other two groups of families. We estimate that 15% of schoolchildren with a cholesterol level above the 95th percentile twice, or 3 per thousand in the general population, have a dominant gene as a cause of the cholesterol elevation.

Adolescent↗