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Biomedical subjects

S T Weiss

Publications and source records attributed to S T Weiss.

At least 253 records · Page 14Linked to original sources
PubMed1985

The relationship of various indices of heart size on chest x-ray to the 10-year incidence of hypertension. The Normative Aging Study.

A total of 598 males (aged 30-74 years) who had baseline (1961-1970) chest radiography and baseline blood pressure less than 140/90 mmHg were observed prospectively for 10 years. Subjects were participants of the Normative Aging Study, a longitudinal study on aging initiated in 1961 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Blood pressures were taken at five- and 10-year follow-up examinations. Multiple logistic regression analysis indicated that the long diameter of the heart (on posteroanterior film) and the cardiac depth (on lateral film) were statistically significant predictors of subsequent hypertension after controlling for baseline body mass index, systolic pressure, and diastolic pressure. A similar model considering various composite indices of heart size indicated that the heart volume was a statistically significant and independent predictor of hypertension. Thus, increases in heart size may precede and predict the development of sustained hypertension.

Adult↗
PubMed1985

The relationship of respiratory infections in early childhood to the occurrence of increased levels of bronchial responsiveness and atopy.

We assessed the relationship of antecedent acute respiratory illness to the occurrence of airway responsiveness and atopy in a population-based cohort of 194 children 12 to 16 yr of age from East Boston, Massachusetts. A history of croup or bronchiolitis as reported by their parents was determined at study onset when the children were 5 to 9 yr of age. During the second and third years of the study, acute respiratory illness was assessed. Five years after the prospective respiratory illness assessment, airway responsiveness was evaluated with eucapneic hyperpnea to subfreezing air, and atopy was evaluated with skin tests to 4 environmental antigens. Both a prior history of croup of bronchiolitis (OR = 2.29, p = 0.04) and greater than 2 acute lower respiratory illnesses (OR = 3.72, p = 0.012) were associated with increased levels of airway responsiveness. Neither index of respiratory illness experience was related to the presence of atopy. However, maternal cigarette smoking was significantly associated with atopy in these children (OR = 2.24, p = 0.02). These data suggest that respiratory illness in early life is associated with airway hyperresponsiveness as measured later in childhood. The data further suggest the need for longitudinal studies to better assess the etiologic role of these potential risk factors.

Adolescent↗
PubMed1985

Effect of cigarette smoking on the pulmonary function of children and adolescents.

The effect of personal cigarette smoking on the growth of lung function in children and adolescents has been assessed in a longitudinal study of a group of 669 subjects 5 to 19 yr of age at initial examination. Subjects were seen annually and assessed with standard questionnaires and measurements of forced expiratory volume in one second (FEV1) and forced expiratory flow during the middle half of the forced vital capacity (FEF25-75). Multiple regression analysis revealed that after correction for previous FEV1 or FEF25-75, age, sex, height, change in height, interactions of age and change in height, and sex and height, and mother's smoking, the personal smoking by the children led to a significant decrease in the rate of growth of FEV1 (p less than 0.001) and FEF25-75 (p = 0.033). On the basis of this analysis, it is estimated that, on average, children who begin to smoke at 15 yr of age and continue to smoke would achieve only 92% (95% confidence limit, 87 to 96%) of their expected FEV1 and 90% (95% confidence limit, 81 to 99%), of their expected FEF25-75 at 20 yr of age. These data suggest that relatively small amounts of cigarette use (median total consumption of 7,300 cigarettes in this study) by adolescents can lead to significant effects on the growth of lung function.

Adolescent↗
PubMed1984

Postural changes in diastolic blood pressure and the risk of myocardial infarction: the Normative Aging Study.

To assess the relationship of postural changes in blood pressure to risk of myocardial infarction, 1359 men were followed for an average of 8.7 years. The men were participants in the Normative Aging Study, a longitudinal study of aging initiated in 1963 at the Veterans Administration Outpatient Clinic in Boston. It was found that the relationship of sitting blood pressure to the subsequent incidence of myocardial infarction was modified by a variable formed by subtracting supine from standing diastolic blood pressure (delta DBP). The effect of sitting diastolic blood pressure on risk of myocardial infarction was confined primarily to men with a delta DBP of 10 mm Hg or more. The effect of sitting systolic blood pressure on risk of myocardial infarction was apparent in all categories of delta DBP (less than 1, 1 to 9, greater than or equal to 10 mm Hg), but the gradient of risk became stronger with increasing levels of delta DBP. The modifying influence of delta DBP remained even when standard coronary risk factors were included in multivariate analyses. These findings suggest a relationship of vascular responsiveness to risk of subsequent myocardial infarction and may have clinical utility.

Adult↗
PubMed1984

Airways responsiveness in a population sample of adults and children.

Nonspecific bronchial responsiveness was assessed with eucapneic hyperpnea to subfreezing air in a population-based sample of 134 adults and 213 children in East Boston, Massachusetts. Increased responsiveness was considered to be present if the decrease in forced expiratory volume in one second with cold air divided by the initial vital capacity was greater than 9%. Men and women had similar bronchial responsiveness, but children and young adults (24 yr of age and younger) were significantly more likely to be responders than were older subjects (p less than 0.001). Children with a doctor's diagnosis of asthma at any time in the past were twice as likely (42.9%) to be responders as were nonasthmatic children (19%) (p = 0.004). Ninety-two percent (11/12) of currently active asthmatics were responders. However, a large percentage of asymptomatic children had increased levels of bronchial responsiveness (18.9%). This cross-sectional study demonstrates the feasibility of measurement of nonspecific bronchial responsiveness in epidemiologic studies, and its relationship to age and wheeze symptoms in children.

Adult↗
PubMed1984

The relationship of airways responsiveness to cold air, cigarette smoking, and atopy to respiratory symptoms and pulmonary function in adults.

The response to eucapnic hyperventilation with subfreezing air was studied in a population based sample of 171 adults, all of whom also completed a respiratory questionnaire, spirometry, and skin testing. A positive response to the cold air challenge was defined as [initial FEV1-post-challenge FEV1)/initial FVC) X 100) greater than or equal to 9%. Cigarette smoking was with a positive cold air response: 12 of 128 current and ex-smokers (9.4%) versus 1 of 43 nonsmokers (2.3%) (p = 0.095). Among current and ex-smokers, a positive response to the cold air challenge was significantly associated with asthma (p = 0.046). Using a logistic regression model, both current smoking and response to cold air were significant predictors of the presence of "persistent wheeze" or asthma. A positive skin test to any of the 4 environmental antigens used (ragweed, housedust, trees, and grasses) was significantly associated with cigarette smoking (p = 0.018) and hay fever (p = 0.003 among current and ex-smokers) but not with wheezing or asthma. Though not statistically significant, cold air responders had a lower percentage of positive skin test reactivity than nonreactors. The findings of this cross-sectional analysis suggest that in adults, both airways responsiveness and cigarette smoking are important predictors of wheezing and asthma. Furthermore, the data suggest that airway hyperresponsiveness and atopy are independent traits. However, in adults, these traits are associated with cigarette smoking, a common environmental exposure.

Child↗
PubMed1984

Pulmonary artery-bronchial fistula complicating chronic lymphocytic leukemia.

A 52-year-old man with chronic lymphocytic leukemia (CLL) entered the hospital because of repetitive bouts of massive hemoptysis requiring a right pneumonectomy. A bronchus intermedius-pulmonary artery fistula was found and felt to be due to necrosis of a peribronchial lymph node which was infiltrated by chronic lymphocytic leukemia cells. This represents another pulmonary complication in the clinical course of advanced CLL.

Bronchial Fistula↗
PubMed1984

The relationship of the peripheral leukocyte count and cigarette smoking to pulmonary function among adult men.

The relationship of the peripheral leukocyte count to pulmonary function was examined in 1,510 men. There were 466 current cigarette smokers, 485 former cigarette smokers, and 559 never smokers enrolled in a longitudinal study of aging. Spirometry was performed twice on all subjects ten years apart. A multiple regression analysis indicated that leukocyte count was inversely related to baseline levels of both forced vital capacity (FVC) (p less than 0.001) and forced expiratory volume in one second (FEV1) (p less than 0.001) after adjustment for age, height, and smoking habits. Similarly, change in leukocyte count over a ten-year period was inversely related to follow-up levels of both FVC (p = 0.036) and FEV1 (p = 0.004) after adjustment for baseline levels of leukocyte count, pulmonary function, age, height, and smoking habits. These data suggest that the peripheral leukocyte count is an important determinant of level of pulmonary function. Further investigation of the pathophysiologic mechanisms involved in this association seems indicated.

Adult↗
PubMed1984

The role of infection in asthma: implications for antibiotic therapy.

Respiratory infection, most prominently bronchiolitis, contracted in infancy is frequently associated with recurrent wheezing episodes and asthma in later life. Atopic individuals and those with a family history of allergy or asthma in first-degree relatives are especially susceptible to the development of chronic airway dysfunction and should be identified early. It is also noteworthy that parenteral cigarette smoking may serve as an additional marker of the high-risk patient. Respiratory infection affecting older children and adults is more commonly due to rhinovirus and influenza A and may cause a transient hyperreactivity to bronchoconstrictor agonists, but does not cause persistent dysfunction. The mechanism(s) by which antecedent respiratory infection is related to recurrent wheezing and asthma remain speculative, and at present a direct causal relationship cannot be established with certainty. Infectious respiratory disorders are also a cause of exacerbations of asthma in adults but more commonly in children, and these also are primarily viral in origin. Consequently, in the absence of clear evidence of bacterial infection, routine antibiotic use in this setting is unwarranted.

Adult↗
PubMed1983

Longitudinal study of the effects of maternal smoking on pulmonary function in children.

We investigated the effects of maternal cigarette smoking on pulmonary function in a cohort of children and adolescents observed prospectively for seven years. A multivariate analysis revealed that after correction for previous forced expiratory volume in one second (FEV1), age, height, change in height, and cigarette smoking in the child, or adolescent, maternal cigarette smoking significantly lowered the expected average annual increase in FEV1 (P = 0.015). On the basis of this analysis, it is estimated that if two children have the same initial FEV1, age, height, increase in height, and personal cigarette-smoking history, but the mother of one has smoked throughout the child's life whereas the mother of the other has not, the difference in the change in FEV1 over time in the exposed child, as compared with that in the unexposed child, will be approximately 28, 51, and 101 ml after one, two, and five years, respectively, or a reduction of 10.7, 9.5, and 7.0 per cent, respectively, in the expected increase. These results suggest that passive exposure to maternal cigarette smoke may have important effects on the development of pulmonary function in children.

Adolescent↗
PubMed1983

The relationship of the baseline ECG to blood pressure change.

A total of 1,090 male participants (aged 23 to 80 years) of the Normative Aging Study who had baseline BP less than 140/90 mm Hg were observed prospectively for ten years. Blood pressures were taken at five- and ten-year follow-up examinations. Multiple linear regression analysis indicated that baseline levels of systolic pressure, age, R-wave amplitude (aVL), hematocrit, T-wave amplitude (V5), and S-wave amplitude (V4, V5, and V6) were statistically significant predictors of systolic pressure change. Baseline levels of diastolic pressure, R-wave amplitude (aVL), and hematocrit were statistically significant predictors of diastolic pressure change. Multiple logistic regression analysis showed that baseline levels of BP, S-wave amplitude (V1, V2, and V3), body mass index, R-wave amplitude (V4, V5, and V6), and T-wave amplitude (V5) were statistically significant predictors of subsequent hypertension. Whether the identified ECG amplitudes are an indicator of early increases in peripheral resistance or a function of neurohumoral factors, or both, is unknown.

Adult↗
PubMed1983

The relationship of the U wave to the 10-year incidence of myocardial infarction.

The relationship between the baseline electrocardiogram and 10-year incidence of myocardial infarction was examined in a cohort of 1013 men. The men were participants in the Normative Aging Study, a longitudinal study of aging initiated in 1963 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Absence of the U wave among these men yielded a relative risk estimate of myocardial infarction of 2.7 as compared to men with a U wave present (95% confidence interval, 1.4-5.2). This association persisted when standard coronary risk factors (cholesterol, blood pressure, and cigarette smoking) were taken into consideration in a multivariate analysis. The results support the conclusion that an abnormality in the electrocardiogram considered to be of little importance indicates an increased risk of myocardial infarction independent of known coronary risk factors.

Adult↗
PubMed1983

Coronary heart disease in police officers participating in the Normative Aging Study.

There is evidence suggesting that male police officers are at a higher risk of developing coronary heart disease than males in the general population. Thus, 1648 men (including 220 police officers and 1428 non-police officers) were followed for 10 years to determine the incidence of coronary heart disease. Subjects were participants of the Normative Aging Study, a longitudinal study of aging initiated in 1963 at the Veterans Administration Outpatient Clinic in Boston, Massachusetts. Comparison of police officers and non-police officers showed no statistically significant differences in the crude incidence rates of coronary heart disease (myocardial infarction, angina pectoris, or death from coronary heart disease) and myocardial infarction alone. When baseline age, serum cholesterol, blood pressure, cigarette smoking, and body mass index were taken into consideration in multiple logistic regression analyses, the lack of significant differences between groups persisted. Police officers relative to non-police officers had an adjusted risk ratio (odds ratio) of 1.4 (95% confidence interval = 0.7-2.4) for coronary heart disease and 1.0 (95% confidence interval = 0.4-2.4) for myocardial infarction. Differences between occupational groups were not statistically significant.

Adult↗
PubMed1983

The relationship of tar content to decline in pulmonary function in cigarette smokers.

The impact of the tar content of cigarettes on pulmonary function was examined in 1,355 men. These men represented 383 current cigarette smokers, 555 former cigarette smokers, and 417 never smokers enrolled in longitudinal study of aging. Current smokers' cigarette exposure was estimated by the number of cigarettes smoked per day and tar content per cigarette. spirometry was performed twice on all subjects at a 5-yr interval. A multiple regression analysis indicated that tar content did not significantly influence baseline levels of forced vital capacity (FVC) or forced expiratory volume in one second (FEV1), after controlling for age, height, and number of cigarettes smoked. Similarly, tar content did not significantly influence follow-up levels of FVC or FEV1, after controlling for age, height, number of cigarettes, and baseline pulmonary function. These data suggest that low tar cigarettes may not protect smokers from an increased rate of decline in pulmonary function.

Adult↗