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Biomedical subjects

S Shapiro

Publications and source records attributed to S Shapiro.

At least 505 records · Page 28Linked to original sources
PubMed1980

Factors associated with oral contraceptive use.

We studied factors associated with oral contraceptive (OC) use among 1,855 premenopausal women who were admitted to hospital with conditions unrelated to OC use. Among this group, 15 per cent reported having used OCs within the preceding year and 35 per cent reported having last used them more than a year previously. A higher estrogenic dose (more than 60 micrograms) was reported by past users; the relationship of numerous other variables to past and present OC use is reported.

Adolescent↗
PubMed1980

Cigarette smoking and age at natural menopause.

In a cohort of 656 naturally postmenopausal women who were interviewed at age 60 to 69 years, and was had reached their menopause between the ages of 35 and 59 years, the mean age at menopause declined with increasing number of cigarettes smoked, from 49.4 years of age among women who had never smoked to 47.6 years of age among women who smoked at least 15 cigarettes per day (p less than 0.02). The relationship was not attributable to the onset of menopause inducing women to take up smoking.

Adult↗
PubMed1980

Rehospitalization in the first year of life for high-risk survivors.

The first year of life is an age when morbidity and medical care use is high, and this is particularly true for low birth weight infants. Whether certain factors characterize subgroups at especially increased risk was examined for a large random sample (N = 4,989) of 1-year-old infants by using rehospitalization as the dependent variable. Overall, 9.1% of the infants had been rehospitalized, and this increased with decreasing birth weight to 38.2% of those less than or equal to 1,500 gm at birth. Low birth weight infants accounted for 6.4% of 1-year-olds, but 13.6% of those hospitalized and 20.0% of all hospital days among these infants. Factors affecting the chances of rehospitalization for low birth weight and normal birth weight infants, with and without congenital anomalies/developmental delay, were similar. Maternal hospitalization during pregnancy, prolonged postnatal stay of the infant, variables indicative of low socioeconomic status, and certain types of medical care use were associated with increased risk of hospitalization. The risk of hospitalization associated with some variables was high, but it was not possible to identify with precision a group where reduction in hospitalization would result in major decrease in overall hospital use by infants.

Analysis of Variance↗
PubMed1979

Oral-contraceptive use in relation to myocardial infarction.

The effect of oral-contraceptive use on the risk of myocardial infarction and, in particular, the possible accentuation of that effect by cigarette smoking, was investigated in 234 premenopausal women with a first infarction and 1742 hospital controls. The overall rate ratio estimate of acute myocardial infarction for women who had used oral contraceptives in the preceding month was 4.0 (95% confidence interval, 2.5--6.3). Women who smoked heavily and used oral contraceptives had a point estimate of 39 (lower two-sided 95% confidence limit, 22) compared with those who did neither. This value was appreciably larger than could be accounted for by the separate effects of cigarettes and oral contraceptives, and this suggests a considerable accentuation by cigarette smoking of the effect of oral contraceptive use on myocardial infarction.

Acute Disease↗
PubMed1979

Current practice of artificial insemination by donor in the United States.

Of 711 physicians likely to perform artificial insemination by donor surveyed to determine their current practices, 471 responded, of whom 379 reported that they performed this procedure. They accounted for approximately 3576 births by this means in 1977. In addition to treating infertility, 26 per cent of these physicians used the procedure to prevent transmission of a genetic disease, and 10 per cent used if for single women. Donors of semen were primarily from universities, were only superficially screened for genetic diseases, and were then matched phenotypically to the recipient's husband. Most recipients were inseminated twice per cycle. Only 17 per cent of physicians used the same donor for a given recipient, and 32 per cent used multiple donors within a single cycle. Only 37 per cent kept records on children, and only 30 per cent on donors. The identity of donors usually was carefully guarded to ensure privacy and to avoid legal complications.

Confidentiality↗
PubMed1979

The relationship between infant mortality rates and medical care and socio-economic variables, Chile 1960-1970.

Infant mortality rates (IMR) have traditionally been considered useful as health status indicators, and changes in these rates are thought to reflect changes in both medical care services and socio-economic circumstances. In order to explore this relationship of IMR with medical core and socio-economic factors in a developing country, Chilean health zone data for the decade 1960--1970 were used to construct 25 variables which were then classified into groups representing antenatal-obstetric services, acute and preventive medical services and socio-economic variables. In an analysis which involved developing a series of linear multiple regression equations for each year of the decade 1960--1970 with IMR as the dependent variable, the percentage of births with professional attention proved to be the stronger variable.

Child Health Services↗
PubMed1979

Patterns and determinants of conjugated estrogen use.

In view of the carcinogenic potential and widespread use of conjugated estrogens (CEs), this study evaluated patterns and determinants of oral ambulatory CE use. Among 1273 women 30 to 69 years of age interviewed in Greater-Boston hospitals, there were 161 (13%) ever-users of CEs; 88 (7%) had used the drug within the preceding year. The median duration of use was three years. Prominent determinants of use were age, menopause and history of menopausal symptoms. Physician prescription survey data from an independent source suggest that CE use has been common throughout the United States, and may have declined after the reports linking CEs to endometrial cancer were published in 1975. If CE use indeed increases the risk of endometrial cancer some fivefold, an important public health problem exists.

Adult↗
PubMed1979

Drug utilization and reported adverse reactions in hospitalized children.

An intensive drug surveillance program has been developed to study the clinical effects of drugs in hospitalized children. This program collects information on drug exposures and the occurrence of adverse clinical events. The 1669 children monitored to date received an average of 7.6 drugs during an average hospital stay of 8.4 days. A group of specified adverse clinical events, whether or not drug attributed, occurred in 45.7% of the patients; drug-attributed events (adverse drug reactions) occurred in 16.8%. Both drug use and reported adverse reactions tended to increase with age, except that newborns received many drugs but had the lowest reported adverse reaction rates. Newborns, however, had the highest rate of adverse events not attributed to drugs, suggesting that perhaps some of these latter events include presently unrecognized adverse drug reactions.

Adolescent↗
PubMed1979

School water fluoridation.

In areas lacking public water supplies and where fluoride is not naturally present in the well water, school fluoridation programs have been shown to be effective and safe. Reductions of up to 38.9% in the rate of dental decay have been reported. Higher levels of fluoride are used in the school water than in public water because of the limited time the children are in school. The relatively low cost of the necessary equipment and chemicals can easily be justified by taking into account the amount of dental decay that can be prevented. Interested parents, teachers, or administrators should contact their state health department for technical assistance.

Child↗
PubMed1979

Matching-to-sample and oddity-from-sample in goldfish.

Acquisition of three-alternative simultaneous matching-to-sample and oddity-from-sample was investigated. Five goldfish were trained on matching and five on oddity for a minimum of 70 days. Subsequently, six of the fish were trained for 70 days on the other task. Acquisition was similar for oddity and matching. Correct responding started at about chance level and slowly increased to about 75%, with some animals performing at levels of over 85%. Acquisition of oddity following matching and matching following oddity began below chance. Maximal level of performance on second-task oddity was comparable to that on first-task matching. By contrast, the maximal levels of performance when matching was the second task were not as high as that of the same subjects at the end of first-task oddity. All fish exhibited strong color preferences during matching acquisition but not during oddity acquisition. The data demonstrated that goldfish can acquire a discrimination in which the stimulus associated with reinforcement depends on the identity of a second stimulus.

Animals↗
PubMed1979

Drug evaluation after marketing.

After marketing, drugs should be evaluated for safety and for efficacy. Present national systems are inadequate for both tasks. Safety can be evaluated by means of nonexperimental research, whereas evaluation of efficacy in a variety of settings representing normal medical practice generally requires experiments, randomized and blinded. Research into safety requires the maintenance of routine, yet flexible, multipurpose data systems, different for established and newly marketed drugs. Ad hoc studies on safety and on efficacy can be mounted more swiftly and economically through the maintenance of "standby" capabilities, in addition to maximal use of resources outside the actual national system.

Drug Evaluation↗
PubMed1979

Drugs and pregnancy.

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Abnormalities, Drug-Induced↗
PubMed1978

Relation of education to sudden death after myocardial infarction.

We studied the influence of social and personal characteristics on prognosis among 1739 male survivors of myocardial infarction who had been monitored for one hour at a standard examination and subsequently followed for mortality. Over a three-year period men with little education (eight years of schooling or less) who had complex ventricular premature beats in the monitoring hour had over three times the risk of sudden coronary death found among better educated men with the same arrhythmia (cumulative mortality of 33 per cent and 9 per cent, respectively). No such differential appeared in the absence of complex ventricular premature beats. Neither risk factors for incidence of coronary heart disease nor clinical characteristics affecting prognosis accounted for the differences observed. There was no relation between education level and risk of recurrent infarction.

Acute Disease↗