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Biomedical subjects

S Shapiro

Publications and source records attributed to S Shapiro.

At least 523 records · Page 29Linked to original sources
PubMed1978

Relation of cigarette smoking to myocardial infarction in young women.

To examine the relation between myocardial infarction and cigarette smoking in young women, we investigated the smoking habits of women under the age of 50 who had survived a recent myocardial infarction. They had not been using oral contraceptives, and other identifiable risk factors were excluded. Among 55 such women and 220 control matched for age and area of residence, the proportions of cigarette smokers were 89 per cent and 55 per cent respectively (P less than 0.001). A dose-response relation was evident; among women smoking 35 or more cigarettes per day the rate of myocardial infarction was estimated to be some 20-fold higher than among those who had never smoked. This study demonstrates that cigarette smoking is a risk factor for myocardial infarction in young women who are otherwise apparently healthy.

Adult↗
PubMed1978

Medical economics survey-methods study: cost-effectiveness of alternative survey strategies.

The Medical Economics Survey-Methods Study was conducted under contract for the National Center for Health Statistics during 1975-76. The objective was to determine the cost-effectiveness of a variety of strategies under consideration for application in a national survey in 1977. Detailed data on health care utilization and expenditures were collected periodically from a panel of 691 Maryland households over a seven-month period. Issues tested through a random experimental design included the relative effectiveness of monthly versus bimonthly interviews and in-person versus telephone contact. Completeness and accuracy of information were determined through an extensive record check involving all providers and third party payers identified in the household check involving all providers and third party payers identified in the household survey. The results indicate that there are substantial deficiencies in the household reporting and that the household data for all types of medical services would benefit from the availability of record data in order to improve theri accuracy. The frequency of contact (monthly versus bimonthly) had little effect on the accuracy of reporting. Given the higher rate of attrition observed for the monthly procedures and their considerably greater cost, the bimonthly interval appears to offer advantages. In-person contact resulted in significantly better reporting compared with telephone contact in the Baltimore area, but no difference was found in more rural Washington County. Thus, the 10 per cent cost increase for in-person contact may well be justified by the improved accuracy of the data obtained for certain types of populations.

Cost-Benefit Analysis↗
PubMed1978

Use of ambulatory health services by the near poor.

Individuals in the gray area between Medicaid eligibility and sufficient income to meet the costs of health care, the near poor, utilize health services less than other groups. As part of a study of health care behavior in an inner-city area based on a household survey of three distinct populations (HMO) members, public housing project residents, and a defined geographical area), we examined this question more thoroughly. Survey results show that the near poor had lower levels of use than Medicaid recipients when other factors were controlled. Particularly among those classified as in poor health, the near poor were more likely to be non-users and less likely to make multiple visits. However, differences in use between the near poor and the Medicaid recipients are substantially and consistently smaller for the HMO users (whose costs were covered by a special contract) than for users of a hospital outpatient department. The patterns persist for regular care received for a chronic condition but not for care sought for episodes of illness. These findings point to the special disadvantage faced by low income individuals who are not receiving Medicaid.

Ambulatory Care↗
PubMed1978

The physicians assistant: a new breed of dental educator.

This article presents the concept of the physicians assistant as a new manpower source for teaching physical diagnosis in the dental school curriculum, and describes the role of the physicians assistant at The University of Oklahoma College of Dentistry. The education and training of the physicians assistant are explored, and his or her qualifications for teaching this type of course are considered. The advantages and cost effectiveness of using this type of educator, rather than a physician, are discussed. Finally, the positive impact of these new educators at Oklahoma is reviewed. Based on our experience, we suggest that other colleges of dentistry investigate this new manpower resource.

Curriculum↗
PubMed1978

Hereditary abnormality of platelet aggregation attributable to nucleotide storage pool deficiency.

An abnormality of platelet aggregation has been detected in six family members with mild bleeding tendencies. In citrated platelet-rich plasma, primary aggregation induced by ADP or epinephrine and agglutination in response to ristocetin were present but second wave aggregation and aggregation in response to collagen suspension were absent or greatly reduced. Sodium arachidonate-induced aggregation was normal although aggregation in response to prostaglandin G2 was reduced and depended entirely on the presence of plasma or ADP. Further tests indicated that the platelets produced prostaglandins but did not release ATP in response to thrombin or sodium arachidonate. Platelets from the patients were found to contain reduced amounts of ADP and 5-hydroxytryptamine and to be unable to retain radioactivity during prolonged incubation at 37 degree C with radiolabeled 5-hydroxytryptamine. Although electron microscopy revealed an absence of very dense bodies, the platelets appeared otherwise normal. The findings are discussed in relation to previous studies of nucleotide storage pool deficiency and the light they shed on platelet physiology in general.

Adenosine Diphosphate↗
PubMed1977

Ventricular premature beats and mortality after myocardial infarction.

To assess the role of ventricular premature beats in influencing mortality of coronary patients, 1739 men with prior myocardial infarction were monitored for ectopic activity for one hour at a standard base-line examination, and followed for mortality for periods up to four years (average, 24.4 months). Analyses of survival taking into account other important prognostic variables establish that the presence of complex premature beats (R on T, runs of 2 or more, multiform or bigeminal premature beats) in the monitoring hour is associated with a risk of sudden coronary death three times that of the men free of complex ventricular premature beats. The corresponding risk of death from any cause is twice that of men without such complex beats in the hour. These arrhythmias make an independent contribution to increased risk of death that persists over the length of this observation period.

Adult↗
PubMed1977

Antenatal exposure to doxylamine succinate and dicyclomine hydrochloride (Benedectin) in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score.

In a prospective cohort study of 20, 282 gravidas and their offspring, congenital malformation rates were similar in the children of over 1,000 women exposed and those not exposed to two components of Bendectin (doxylamine succinate and dicyclomine hydrochloride) during the first four lunar months of pregnancy. In a cohort reduced to 41,337 mother-child pairs for technical reasons, mean birth weight and perinatal mortality rates were similar according to exposure or nonexposure to either drug, as were intelligence quotient scores measured at four years of age in 28,358 of the children. Control of potential confounding factors with a variety of multivariate techniques did not materially alter these findings.

Abnormalities, Drug-Induced↗
PubMed1977

Antenatal exposure to the phenothiazines in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score.

In a prospective cohort study of 50,282 gravidas and their offspring, over-all rates of congenital malformations were similar in 1,309 children of women exposed to phenothiazine drugs during the first four lunar months of pregnancy and in 48,973 children of women who were not exposed. There was a suspicion of association between phenothiazine exposure and cardiovascular malformations. In a cohort reduced to 41,337 mother-child pairs for technical reasons, perinatal mortality rates and mean birth weight were similar according to phenothiazine exposure or nonexposure, as were intelligence quotient scores measured at four years of age in 28,358 of the children. Control of potential confounding factors with a variety of multivariate techniques did not materially alter the findings.

Abnormalities, Drug-Induced↗
PubMed1977

Oxygen-induced consumptive coagulopathy and its enhancement by lead acetate.

The exposure of rats to 100% oxygen at 1 atmosphere leads to a prolongation of prothrombin times and activated partial thromboplastin times. This development is associated with a consumption of factor XII, VIII, and VII activities and with the appearance of fibrin monomers and fibrinogen degradation products. Lead acetate enhances all oxygen-induced changes of the coagulation systems drastically. The O2 survival time of chicks which are naturally deficient in factor XII is greatly increased over that of rats and is not affected by lead acetate. Oxygen survival times of rats suffering from chronic respiratory disease (CRD) are also significantly increased when compared with normal rats. It appears that consumptive coagulopathy and disseminated intravascular coagulation are early events in oxygen exposure, and that their development is accelerated by lead ions.

Animals↗
PubMed1977

Cardiovascular birth defects and antenatal exposure to female sex hormones.

In a cohort of 50,282 pregnancies 19 children with cardiovascular defects were born to 1042 women who received female hormones during early pregnancy (18.2 per 1000). Among 49,240 children not exposed in utero to these agents there were 385 with cardiovascular malformations (7.8 per 1000). Six children with cardiovascular defects were born to a sub-group of 278 women who used oral contraceptives during early pregnancy (21.5 per 1000). After the data were controlled for a wide variety of potentially confounding factors by multivariate methods, the association between in utero exposure to female hormones and cardiovascular birth defects was statistically significant.

Adult↗
PubMed1977

Cyclic adenosine 3':5'-monophosphate-mediated insulin secretion and ribosomal protein phosphorylation in a hamster islet cell tumor.

In order to understand the mechanism by which cyclic 3':5'-adenosine monophosphate (cAMP) regulates insulin secretion, cAMP-dependent protein phosphorylation was studied in a transplantable hamster islet cell tumor. Single cell suspensions prepared by enzymatic digestion of the tumors released insulin into the incubation media. Glucagon (3 nM to 3 muM) stimulated cellular cAMP accumulation and insulin release in a dose-dependent manner and these effects were enhanced by 1 mM theophylline. 8-Bromoadenosine 3':5'-monophosphate (8Br-cAMP) (1 mM) increased insulin release. Somatostatin (10 mug/ml) inhibited basal and glucagon or 8Br-cAMP-stimulated insulin release without significantly lowering cellular cAMP in glucagon-stimulated cells. For analysis of phosphoproteins, cells were incubated with carrier-free 32Pi following which lysates were prepared and analyzed by sodium dodecyl sulfate slab gel electrophoresis and autoradiography. Of the numerous 32P-labeled protein bands found, only one (P1, Mr = 28,000) displayed a significant increase in 32P incorporation when cells were incubated under conditions that raise the concentration of cellular cAMP. Somatostatin did not affect 32P incorporation into P1 or any other protein band. When cells were incubated with glucagon, an increase in cellular cAMP was evident after 1 min, enhanced 32P incorporation into P1 after 1 to 5 min, and stimulation of insulin release after 5 to 10 min. Analysis of subcellular fractions led to the designation of P1 as a 40 S ribosomal protein. Two-dimensional electrophoresis of 32P-labeled basic ribosomal proteins showed two labeled proteins, P1 and P2, both of which were localized to the 40 S ribosomal subunit. Only phosphorylation of P1 was stimulated by cAMP. The cAMP-dependent ribosomal phosphoprotein, P1, may be identical with a ribosomal phosphoprotein demonstrated in a variety of tissues and species. Its physiological role remains to be established.

Adenoma, Islet Cell↗