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Biomedical subjects

S Shapiro

Publications and source records attributed to S Shapiro.

At least 487 records · Page 27Linked to original sources
PubMed1980

Use of thyroid supplements in relation to the risk of breast cancer.

We conducted a case-control study to determine whether the use of thyroid supplements increases the risk of breast cancer. We compared 659 women with breast cancer and 1,719 control subjects. The rates of use of thyroid supplements were 9.1% and 8.7%, respectively (age-standardized rate ratio, 1.0; 95% confidence interval, 0.7 to 1.3). There was no evidence of an association when women known to be at increased risk for breast cancer (eg, nulliparae) were examined, even when thyroid supplements were taken for more than 15 years. Overall, there were no grounds to suggest that the long-term use of thyroid supplements increases the risk of breast cancer.

Adult↗
PubMed1980

Thiazides and acute cholecystitis.

An association between acute cholecystitis and the use of thiazide-containing drugs was observed during routine screening of data from a case-control drug-surveillance program. Evaluation of this relation among 419 patients with acute cholecystitis and 1676 control patients yielded a relative risk estimate of 2.0 for subjects who had used thiazides in the month before admission, as compared with subjects who had never used these drugs (95 per cent confidence interval, 1.4 to 2.7). There was a significant trend of increasing relative risk with increasing duration of use (P < 0.01), and the estimate for subjects who had used thiazides for five or more years was 2.9. The association was not explained by confounding due to the indications for thiazide use, such as hypertension, or other factors, such as obesity or the use of other drugs. No single epidemiologic study can eliminate chance or bias as an explanation for an association; the relation found here should be regarded as a hypothesis that requires independent confirmation.

Acute Disease↗
PubMed1980

Recent and past use of conjugated estrogens in relation to adenocarcinoma of the endometrium.

It has been suggested that the reported association between estrogen use and endometrial cancer may have been biased because estrogens provoke uterine bleeding in women with otherwise asymptomatic disease. To evaluate this hypothesis we compared 149 patients with endometrial cancer and 402 control subjects with other conditions with reference to the time when they had last used conjugated estrogens. In women who had last used conjugated estrogens two or more years previously and who had taken them for at least five years, the rate-ratio estimate was 3.3 (95 per cent confidence interval, 1.4 to 8.0) relative to women who had never used them. Uterine bleeding, and hence the diagnosis of otherwise asymptomatic cancer, cannot be attributed to estrogen use that ceased in the distant past. Our results suggest that such use has a residual effect on the risk of endometrial cancer; this effect is not accounted for by biased selection of cases according to estrogen use.

Adenocarcinoma↗
PubMed1980

Noncontraceptive estrogens and myocardial infarction in young women.

The effect of noncontraceptive estrogens on the risk of myocardial infarction (MI) in women aged 30 to 49 years was investigated in 477 women with first infarctions and in 1,832 hospital control subjects. There was little evidence of an effect: overall, the estimated relative risk of acute MI for women who had used noncontraceptive estrogens in the preceding month, after allowance for potential confounding factors, was 1.0 (95% confidence intervals, 0.6 to 1.7); the corresponding estimate for women who had discontinued use more than one month previously was 1.2 (0.8 to 1.8). There was also no apparent association in various subgroups, including women who smoked heavily and those who had no identified predisposition.

Adult↗
PubMed1980

Relevance of correlates of infant deaths for significant morbidity at 1 year of age.

This paper examines the issue of whether or not factors identified as risks for death in the first year of life also serve as risks for morbidity in surviving infants through data collected on 390,425 live births, 5,084 infant deaths, and 4,327 surviving 1-year-old children among singleton births in eight geographically defined regions in the United States. Factors which presented risks for neonatal death, such as advanced maternal age and maternal history of prior fetal loss, proved to present risks for congenital anomalies/severe developmental delay, whereas factors heavily influenced by environmental conditions, such as young maternal age and lower maternal educational attainment, were associated with higher postneonatal mortality rates and other significant illness, among both low-birth-weight and normal-birth-weight infants. The association of delivery by cesarean section with death and morbidity was also explored.

Adolescent↗
PubMed1980

Intrauterine contraceptive device use and pelvic inflammatory disease.

We examined the relationship between use of IUD's and PID, based on 44 women who were admitted to hospitals with first episodes of PID and 259 hospital control subjects. All the women used either IUD's or oral contraceptives. The age-adjusted relative risk for those using IUD's at the time of admission was 6.5 (95% confidence interval, 3.2 to 13.0). The association remained when several variables, and particularly parity, were taken into account. There was a suggestion that users who had had an IUD in place for at least 5 years had a higher risk of PID than did users of shorter duration. The data also suggest that copper-containing IUD's may be safer than other devices.

Adult↗
PubMed1980

Psychophysiological effects of autogenic training and progressive relaxation.

Although autogenic training and progressive relaxation are widely used relaxation techniques, little research has been conducted on their comparative effects. Twenty-two normal subjects received five sessions of instruction in either progressive relaxation or autogenic training over a 5-week period. Both types of training, when compared to the control group, significantly decreased SCL-90 scores on four scales: anxiety, depression, number of symptoms, and intensity of symptoms. Also, autogenic training appeared to produce specific effects on self-perception of heaviness and warmth in the limbs and depth of breathing. However, there were no significant differences between groups in pretest versus posttest changes in heart rate or skin conductance. These results are consistent with the results of other recent research on nonanxious individuals in this laboratory.

Adult↗
PubMed1980

Reorganization of a medical house staff (firm system): its effect on accessibility and continuity of care.

In 1975, the Johns Hopkins Medical house staff was reorganized into four Firms. Each Firm provides inpatient and outpatient care to a group of patients. Two of the goals of the reorganization were to improve accessibility and continuity of care. This study, based on a before and after research design utilizing routinely collected data, sought to determine whether these goals had been attained. Accessibility was assessed by observing changes in waiting time for appointments, broken appointments, and number of patients seen before their scheduled appointments. The results showed that mean waiting time for a Medical Clinic appointment fell from 15 days to 1 day (p < 0.01); broken appointments for new patients fell from 54% to 34% (p < 0.01); no significant changes occurred in broken appointments for old clinic patients (34% vs 32%); and patients seen before their scheduled appointments increased from 30% to 38% (p < 0.001). Continuity was assessed by observing changes in use of emergency and walk-in clinic services, the proportion of Medical Clinic patients lost to follow-up care, the proportion of hospital readmissions returning to the same nursing unit, and the proportion of patients discharged from the hospital who returned to the Medical Clinic. The results showed that use of emergency and walk-in clinic services fell slightly, from 24% of all visits before to 22% of all visits after the Firm System (p < 0.001); no change occurred in the proportion of patients lost to Medical Clinic follow-up (21% before and after the Firm System); the proportion of hospital readmissions returning to the same nursing unit increased from 35% to 73% (p < 0.005); and the proportion of patients discharged from the hospital who returned to the Medical Clinic increased from 21% to 35% (p < 0.001). These data suggest that implementing the Firm System led to improvement in several selected aspects of accessibility and continuity of care but that further improvements could be made.

Ambulatory Care↗
PubMed1980

Successful suicides and serious attempts in a general hospital over 15-year period.

The occurrence of suicide in the general hospital was studied in terms of incidence, age groups, and diagnostic category. The authors describe both physical and psychiatric syndromes that seem to be connected with higher vulnerability for self-destructive acts. Suicidal behavior was not found to be a random or impulsive act, but rather the final expression in action of already communicated clues in many instances. The bimodal distribution of two separate age and diagnostic groupings is described and can serve as a basis for a heightened awareness of the suicidal potential in these patients.

Adult↗
PubMed1980

Association of coronary atherosclerosis with hyperapobetalipoproteinemia [increased protein but normal cholesterol levels in human plasma low density (beta) lipoproteins].

Most patients with coronary artery disease do not have elevated plasma or low density lipoprotein (LDL) cholesterol. To test whether the protein moiety of LDL, LDL B, might be a parameter to identify ischemic heart disease, the plasma cholesterol, triglyceride, LDL cholesterol, and LDL B were measured in 100 consecutive patients undergoing cardiac catheterization. On the basis of coronary angiography, these patients were divided into two groups: group I, 31 patients without, and group II, 59 patients with significant coronary artery disease. Although cholesterol, triglyceride, and LDL cholesterol levels were all significantly higher in group II, discriminant analysis indicated that LDL B concentrations most clearly separated the two groups. In group I (noncoronary), LDL B was 82 +/- 22 mg/100 ml, whereas in group II, LDL B was 118 +/- 22 mg/100 ml. The B protein level in group I was similar to other normal groups studied (35 asymptomatic male physicians, 83 +/- 11 mg/100 ml; 90 normolipidemic medical students, 72 +/- 17 mg/100 ml). The results therefore indicate that not only does LDL B better separate coronary and noncoronary groups than other lipid parameters studied, but also, among those with coronary artery disease, there exists a group with normal LDL cholesterol but with levels of LDL B protein similar to those observed in type II hyperlipoproteinemia. The explanation for the altered LDL composition observed in this group remains to be elucidated.

Apolipoproteins↗
PubMed1980

Cigarette smoking in relation to the risk of myocardial infarction in young women. Modifying influence of age and predisposing factors.

We evaluated the relation between myocardial infarction (MI) and cigarette smoking in women 30 to 49 years of age. Among 318 women who had survived recent first infarctions and 1272 age-matched controls, the proportions of cigarette smokers were 83% and 54%, respectively (p < 0.001). The estimated relative risk rose progressively with amount smoked: compared with women who had never smoked, the estimate was 1.8 for smokers of less than 15 cigarettes per day and 6.9 for smokers of 35 or more cigarettes per day. At each level of smoking, the relative increase in risk was greater at younger ages and among those not apparently predisposed from other factors. Although MI is a rare disease in young women, our data indicate that the risks faced by those who smoke heavily are appreciable.

Adult↗
PubMed1980

Coffee drinking and myocardial infarction in young women.

The effect of consumption of caffeine-containing coffee on the risk of myocardial infarction in women 30-49 years of age was investigated. In this study 487 patients with first infarctions were compared with 980 controls whose admissions were for acute emergencies. Overall and in various subgroups, coffee drinking and myocardial infarction were weakly and not significantly associated: the overall estimated relative risk for women drinking at least five cups daily, compared with women drinking none, was 1.4 after control for all identified potential confounding factors (95% confidence interval, 1.0-1.9). Also, the frequency of coffee drinking was greater among controls, whose admissions were for acute emergencies, than among other patients without myocardial infarction, most of whom had been admitted for chronic conditions. If patients of the latter type tend to avoid coffee, then their inclusion in the control series of previous hospital-based studies may have led to overestimation of the magnitude of the association between coffee and myocardial infarction.

Acute Disease↗
PubMed1980

Methyl-coenzyme M, an intermediate in methanogenic dissimilation of C1 compounds by Methanosarcina barkeri.

Extracts of Methanosarcina barkeri possess a specific methyltransferase that catalyzes the transfer of the methyl group of methanol to 2-mercaptoethanesulfonic acid. Over a fourfold range in added 2-mercaptoethanesulfonic acid, the formation of 2-(methylthio)ethanesulfonic acid exhibited a 1:1 ratio to 2-mercaptoethanesulfonic acid added. This reaction required adenosine 5'-triphosphate; a maximal ratio (mole/mole) of 85 methyl groups was transferred per adenosine 5'-triphosphate added. The methyltransferase was found in extracts of methanol-grown cells as well as in extracts of hydrogen-grown cells. In extracts of cells grown on either substrate, 2-(methylthio)ethanesulfonic acid was formed from added methanol or methylamine but not from acetate.

Adenosine Triphosphatases↗
PubMed1980

Ventricular premature complexes in prognosis of angina.

We studied the prognostic role of ventricular premature complexes occurring during 1 hour of electrocardiographic monitoring of 416 men with effort angina who had never had myocardial infarction, and compared mortality over 5 years with that of 1739 men with infarction before first observation. Multivariate analyses of survival identified the presence of ventricular premature complexes in 1 hour of monitoring, the presence of ST-segment depression on the standard ECG, and age as the variables making the most important independent contributions to risk of death (all causes and sudden coronary deaths) among the men with angina. The relatively lower age-adjusted 5-year mortality among men with angina compared with those who had a prior myocardial infarction reflects the lower prevalence in the former group of indicators of myocardial dysfunction, such as ventricular ectopic activity and ST-segment depression.

Adult↗