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Biomedical subjects

S Shapiro

Publications and source records attributed to S Shapiro.

At least 397 records · Page 22Linked to original sources
PubMed1985

Alcoholic beverages and myocardial infarction in young men.

Previous studies have suggested that people who consume a moderate amount of alcohol have a reduced risk of coronary heart disease compared with nondrinkers. This hypothesis was further tested in the period April 1980-April 1983 in a study of 2,170 men with first nonfatal myocardial infarction and 981 hospital controls, all under 55 years of age. The relative risk estimate for men who drank between one and seven times per week compared with never drinkers was 1.2 (95% confidence interval, 0.8-1.8) when age and cigarette smoking were taken into account and 1.1 (0.7-1.7) when personality type was also taken into account. There was no evidence of a reduced risk for users who drank primarily one type of alcoholic beverage (beer, wine, or liquor) or within categories of dose measured in ounces consumed per week. The findings were not materially changed when other risk factors for myocardial infarction were taken into account. The results of this study suggest that moderate alcohol consumption does not reduce the risk of nonfatal myocardial infarction.

Adult↗
PubMed1985

Breast cancer and the consumption of coffee.

The hypothesis has been raised that coffee consumption may increase the incidence of breast cancer, based on the report that fibrocystic breast disease, a risk factor for breast cancer, regresses after abstention from coffee and other methylxanthines. The relation between recent coffee consumption and the risk of breast cancer was evaluated in a case-control study, based on interviews conducted 1975-1982 at several mainly eastern US teaching and community hospitals. The responses of 2,651 women with newly diagnosed breast cancer were compared with those of 1,501 controls with nonmalignant conditions and 385 controls with cancers at other sites. The relative risk estimates for levels of coffee drinking up to seven or more cups daily, relative to none, approximated 1.0 with narrow 95% confidence intervals. After allowance for confounding, the relative risk estimate for drinking at least five cups a day was 1.2 (95% confidence interval, 0.9-1.6) using the noncancer controls and 1.1 (0.7-1.6) using the cancer controls. Coffee consumption was not associated with an increase in the risk of breast cancer among women with a history of fibrocystic breast disease, nor were tea or decaffeinated coffee associated with an increase in the risk of breast cancer. The results suggest that the recent consumption of coffee does not influence the incidence of breast cancer.

Adult↗
PubMed1985

Rating AIS severity using emergency department sheets vs. inpatient charts.

To determine whether sufficiently accurate estimates of injury severity can be based on limited data as would be available from an Emergency Department (ED) Sheet, Abbreviated Injury Severity (AIS) scores were derived for 166 trauma patients using two different sources of data--the ED sheet and inpatient medical chart. These severity scores were compared by type of person assigning the scores and by external cause of the injury. Results indicate that in general, the ED sheet is not a suitable alternative to the complete inpatient chart when coding severity for individuals who sustain injuries severe enough to result in hospital admission.

Diagnosis-Related Groups↗
PubMed1985

The utility of synthetic and regression estimation. Techniques for local health planning.

Health planning agencies have long had a need for local area data on issues such as health status, utilization, and preventive care. Synthetic estimation and regression techniques have been advanced for use in adjusting national or regional data from the NCHS Health Interview Survey (HIS) to the local area based on demographic and other pertinent variables. To evaluate the accuracy and utility of these techniques for local health planning, estimates of certain key HIS variables were obtained from a telephone survey of 2,500 randomly selected households located in the Central Maryland Health Systems Agency (CMHSA). This paper presents results of the comparison between these telephone estimates and the corresponding estimates derived from the national HIS. The techniques are evaluated on the basis of data generally available to local planning agencies.

Catchment Area, Health↗
PubMed1985

The Abbreviated Injury Scale and Injury Severity Score. Levels of inter- and intrarater reliability.

Given the wide usage and proven value of the Abbreviated Injury Scale (AIS) in rating severity of trauma, it is essential that certain reliability issues concerning its application be resolved. This article describes a study designed to address these reliability issues. Each of 15 raters with varying qualifications was asked to identify AIS code injuries sustained by 375 trauma patients admitted to four Baltimore area hospitals. Results showed that as a group, physicians and nurses tend to be more reliable in their ratings than either emergency medical technicians (EMTs) or nonclinical technicians, although a research assistant who is well trained in AIS coding and is a diligent worker can use the AIS to code severity as reliably as the physicians when sufficient information is provided in the medical chart. Reliability of AIS scoring was somewhat higher for blunt (vehicular and nonvehicular) versus penetrating injuries.

Costs and Cost Analysis↗
PubMed1985

Measuring need for mental health services in a general population.

This article presents measures of need for mental health services estimated from the 1981 Eastern Baltimore Mental Health Survey, one of five sites participating in the NIMH Epidemiologic Catchment Area Program. Data were collected on the prevalence of specific psychiatric disorders, as determined by the standardized Diagnostic Interview Schedule (DIS), functional status, personal characteristics, patterns of medical and mental health care, and sources of care used. Need is based on mental health services use in the prior 6 months or the presence of two or more manifestations of emotional problems: a) one or more DIS disorders present in the past 6 months, b) a General Health Questionnaire (GHQ) score of four or more current symptoms, or c) the respondent's report of having been unable to carry out usual activities in the past 3 months for at least 1 entire day because of an emotional problem. Approximately 14% of adults met the criteria for need, half of whom had made no mental health visits in the prior 6 months and were considered to have unmet need. Need for care was influenced by a variety of sociodemographic and economic characteristics: it was low among the aged and high among persons living alone and the poor on Medicaid. The proportion of need that was unmet varied less but was relatively large for two groups, the aged and nonwhites. Those on Medicaid through public assistance were more likely to have their need met than the near poor.

Adult↗
PubMed1985

Mental health of the elderly: use of health and mental health services.

The utilization of services by older patients with mental morbidity is examined in this paper. The population is drawn from a large, multi-site study, the Epidemiological Catchment Area studies, and reports on the findings from the Baltimore, Maryland, site, The Eastern Baltimore Mental Health Survey. The fact that older individuals with mental disorders are less likely to be seen and treated for these disorders than are younger individuals was substantiated by data from this study. Of those under age 65, 8.7 per cent have made a visit to a specialty or primary care provider for mental health care; for those age 65 to 74, the rate is 4.2 per cent, and of those 75 and over, only 1.4 per cent have had such care. In this last group, 75 and over, not a single person saw a specialty mental health provider. The likeliest source of care for older individuals for emotional or psychiatric problems is their primary care providers within the context of a visit made for physical medical problems. Past work and these data suggest that the factors that influence this low level of care can be found in the characteristics of the population as well as in the characteristics of the health care system. The implications of these findings are discussed.

Adolescent↗
PubMed1985

Effect of ammonium on chloramphenicol production by Streptomyces venezuelae in batch and continuous cultures.

Cultures of Streptomyces venezuelae presented with a mixture of ammonium and an amino acid as nitrogen sources used both compounds together. Absence of ammonium repression of alternative nitrogen assimilation pathways was also observed when ammonium was added to cultures already growing on proline. The presence of ammonium in the medium ab initio depressed the yield of chloramphenicol. However, its addition to a culture growing on proline caused only a temporary inhibition of antibiotic synthesis, even when sufficient ammonium was added to create an excess. Continuous cultures supplied with ammonium as the growth-limiting nutrient showed no significant change in specific antibiotic production at different specific growth rates. The overall results indicate that in S. venezuelae neither nitrogen utilization pathways nor chloramphenicol biosynthesis is controlled by nitrogen repression.

Bacteriological Techniques↗
PubMed1985

Pathway of ammonium assimilation in Streptomyces venezuelae examined by amino acid analyses and 15N nuclear magnetic resonance spectroscopy.

To obtain information on the route(s) of ammonium assimilation in Streptomyces venezuelae, cell suspensions transferred to fresh medium lacking nitrogen were pulsed with [15N2]ammonium sulphate. Cells and extracellular fluids were examined by nuclear magnetic resonance and amino acid analysis to assess changes in amino acid pools and the disposition of [15N]ammonium. Following addition of [15N]ammonium, glutamate--glutamine pools of low cell density replacement cultures expanded rapidly and became progressively labelled with 15N, whereas the alanine pool size increased much more slowly and became labelled with 15N to a much lesser extent. These results are consistent with the assimilation of ammonium via glutamate dehydrogenase or glutamine synthetase--glutamate synthase rather than alanine dehydrogenase. Under anaerobic conditions, S. venezuelae assimilates ammonium into alanine rather than glutamate--glutamine. Alanine dehydrogenase may thus function as a vehicle to regenerate NAD+ to maintain substrate-level phosphorylation during periods of anaerobiosis.

Alanine↗
PubMed1985

Alzheimer's disease: an emerging affliction of the aging population.

Alzheimer's disease is one of several brain disorders under the broad category of dementia. It is a gradually debilitating illness with no known cure. The first symptom is usually a slowly increasing memory loss, beginning between 40 and 65 years of age. As the disease progresses, the brain begins to deteriorate more rapidly, until it literally stops functioning. Of great concern is the projection that the number of people who will have Alzheimer's disease will double by the year 2030 because of the rising elderly population. Treating this population will escalate from the current estimate in excess of $2.5 billion to more than $6 billion. Speculation toward the increasing costs in money and workforce has led to an accelerated program in search of a cure or at least a symptomatic therapy for this condition. One of the most promising research leads is the striking connection between Alzheimer's disease and Down's syndrome and certain cancers: --Virtually 100% of patients with Down's syndrome who survive past age 35 show the same mental deterioration and identical brain changes seen in patients with Alzheimer's disease, including the presence of plaque and neurofibrillary tangles.--The presence of a high percentage of Down's syndrome among relatives of patients with Alzheimer's disease. --A high incidence of certain types of syndrome and among relatives of people who have Alzheimer's disease, such as leukemia, lymphomas, Hodgkin's disease, and immune system disorders. The key to the intercorrections between Alzheimer's disease and Down's syndrome seems to be a genetic component related to chromosome 21.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1985

Selection, follow-up, and analysis in the Health Insurance Plan Study: a randomized trial with breast cancer screening.

Critical decisions made 20 years ago by those who planned the randomized trial at the Health Insurance Plan (HIP) of Greater New York to determine the efficacy of periodic screening for breast cancer are detailed. These decisions affected the age group to be screened, screening modalities, frequency of screening, sample size, primary measures for testing efficacy, and period of follow-up (long term). Results of follow-up, 16 years after entry, indicate that mortality due to breast cancer continues to be lower among study women than controls. Numerically, the differential has been stable; relatively, it has decreased. It is estimated that the study group would have experienced about a 30% reduction in breast cancer mortality if screening had been maintained. Relative case survival rates over a 14-year period after diagnosis show changes in contours of trend lines that result from screening. The study group's trend is slightly concave in contrast to the usual convex curve for the controls. The contour of the curve is more decidedly concave among subjects detected through mammography alone than for other subgroups detected through screening, although the relative survival rate remains highest in the mammography only group. Uncertainty persists about effects of screening in the HIP study on breast cancer mortality among women aged 40-49 years at entry.

Adult↗
PubMed1984

Noncontraceptive estrogen use and the risk of breast cancer.

The relation between the risk of breast cancer and the use of noncontraceptive estrogens was investigated in a hospital-based study of 1,610 women with breast cancer and 1,606 with other conditions. The overall relative risk estimate for conjugated estrogens first taken at least 18 months before admission, compared with never-use of any noncontraceptive estrogens, was 0.9 (95% confidence interval, 0.7 to 1.1). For other estrogens first taken at least 18 months before admission, the estimate was 0.8 (0.6 to 1.1). The results were similar when known risk factors for breast cancer were taken into account. Among postmenopausal women, conjugated estrogens did not appear to increase the risk of breast cancer, even when taken for many years or in the distant past. There was no evidence of an increased risk due to conjugated estrogen use among subgroups of women defined according to various risk factors for breast cancer. The results of this study suggest that noncontraceptive estrogens do not increase the risk of breast cancer.

Adult↗
PubMed1984

Breast cancer and cigarette smoking.

It has been suggested that cigarette smoking may reduce the incidence of breast cancer, perhaps by as much as 20 per cent. To evaluate the relation between breast-cancer risk and smoking, we studied 2160 women with breast cancer and 717 controls who had been admitted to the hospital for cancer of the ovary, cancer of the colon or rectum, malignant melanoma, or lymphoreticular cancers. As compared with women who had never smoked, the estimated relative risk of breast cancer was 1.1 for current smokers of any amount (95 per cent confidence interval, 0.9 to 1.3), and 1.0 (0.8 to 1.3) for heavy smokers (15 or more cigarettes per day). Allowance for all identified potential confounding factors did not materially alter the results. There was no indication that age at commencement of smoking was related to the risk, nor was there evidence of an effect of smoking within the categories of age at first pregnancy or age at menopause. The data provide evidence against the hypothesis that smoking may reduce the incidence of breast cancer by 20 per cent.

Adult↗