Biomedical subjects

Steven J Jacobsen

Publications and source records attributed to Steven J Jacobsen.

At least 73 records · Page 4Linked to original sources

PubMed2005

Longitudinal changes in post-void residual and voided volume among community dwelling men.

PURPOSE: We describe the natural history of post-void residual (PVR) and voided volume (VV) in men. MATERIALS AND METHODS: A random sample of community dwelling men (529 men 40 to 79 years old) were followed with a sonographic PVR and VV every 2 years for up to 12 years (median 5 examinations). Men were censored at the time of treatment for a prostate condition. RESULTS: The median annual change (slope) for PVR was 2.2% (p=0.03) and for VV was -2.1% (p <0.0001). There was considerable variability in PVR slopes (25th percentile -11%, 75th percentile 18%). A rapid increase in PVR slope (greater than 80th percentile) was more likely in men with a baseline American Urological Association Symptom Index greater than 7 (age adjusted odds ratio [OR]1.6, 95% CI 1.0 to 2.5). There was less variability in VV slopes (25th percentile -8.0%, 75th percentile 3.1%). A rapid decrease in VV slope (less than 20th percentile) was more likely in men with baseline age 70 to 79 years than 40 to 49 years (OR 3.9, 95% CI 2.1 to 7.2) and in men with a baseline PVR greater than 50 ml (age adjusted OR 2.1, 95% CI 1.2 to 3.6). CONCLUSIONS: Although it is highly variable, there is progressive bladder dysfunction in community dwelling men as they age. In addition, signs and symptoms attributed to benign prostatic hyperplasia were modest predictors of the development of bladder dysfunction. A baseline increased PVR predicted a rapid decrease in VV, consistent with a bladder outlet obstruction contributing to the development of detrusor overactivity and decreased bladder compliance.

Adult↗

PubMed2005

Prevalence of conditions potentially associated with lower urinary tract symptoms in men.

OBJECTIVE: To estimate the frequency of conditions associated with lower urinary tract symptoms (LUTS, typically included when assessing benign prostatic hyperplasia, BPH), as other causes of LUTS should be excluded when diagnosing BPH, using data from the Olmsted County Study of Urinary Symptoms and Health Status among Men. SUBJECTS AND METHODS: During 1989-91, Caucasian men aged 40-79 years were randomly selected from the Olmsted County population. Before contact, eligibility was determined by reviewing the community medical records. Baseline exclusion criteria included comorbid pre-existing conditions or treatments, e.g. prostate, bladder or lower back surgery, bladder neck contracture or cancer, diabetes with lower extremity amputation, and neurological diseases, including Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, tabes dorsalis and stroke. Men with these conditions were excluded from the Olmsted County Study at baseline, because these conditions are potentially associated with LUTS. RESULTS: Of the 5100 randomly sampled men, 13.4% met at least one of the pre-existing exclusion criteria. Individually, the frequency of exclusions was 7.8% for prostate cancer or surgery, 4.8% for back surgery, 1.3% for bladder surgery and 1.4% for neurological conditions. All other conditions represented <1.0% of the study exclusions. Older men were more likely to meet at least one of the exclusion criteria, with men in their fifth to eighth decade having a total exclusion frequency of 1.4%, 5.4%, 8.5% and 32.8%, respectively. The most common reason for men in their fifth decade to be excluded was lower back surgery (0.9%), whereas the most common reason in the eighth was prostate surgery (21.8%). CONCLUSIONS: In men, conditions that may contribute to LUTS, other than BPH, are prevalent in the community and increase in frequency with age. It is important that other conditions associated with LUTS be excluded before a definitive diagnosis of BPH. Any oversight in this initial evaluation can potentially result in misclassification bias, misdiagnosis and incorrect treatment of patients.

Adult↗

PubMed2005

Decline in the overall incidence of regional-distant prostate cancer in Olmsted County, MN, 1980-2000.

OBJECTIVE: To describe trends in the incidence of regional-distant prostate cancer over the entire course of the disease, before and after the introduction of prostate-specific antigen screening in 1987. PATIENTS AND METHODS: All residents of Olmsted County, MN, USA, with a diagnosis of prostate cancer from 1964 to 2000 were identified using the resources of the Rochester Epidemiology Project. Their community medical records were examined to identify men with documented evidence of locally advanced (T3/4 or N+ disease) or metastatic prostate cancer between 1980 and 2000. RESULTS: In all, 407 men had regional-distant prostate cancer, based on clinical or pathological staging at the time of initial diagnosis of prostate cancer and/or on radiological information over the entire course of their illness. The age-adjusted incidence per 100,000 men increased from 47.4 in 1980-86 to 65.8 in 1987-93, and declined to 33.3 in 1994-2000 (P < 0.001). Based on clinical and radiological information over the entire course of illness (268 men) the age-adjusted incidence of regional-distant disease was 42.3 in 1980-86, 41.2 in 1987-93, and declined to 18.1 in 1994-2000 (P < 0.001). These latter rates were 27%, 32% and 47% higher for the three periods, respectively, than rates based on clinical staging at initial diagnosis of prostate cancer. CONCLUSIONS: The overall incidence of regional-distant stages of prostate cancer has declined in recent years, regardless of the stage at initial diagnosis. This may be a result in part of early detection and curative treatments. These findings also indicate that assessing the incidence of regional-distant prostate cancer only at the initial diagnosis underestimates the full impact of the benefits of early detection and treatment.

Age of Onset↗

PubMed2005

The association between benign prostatic hyperplasia and chronic kidney disease in community-dwelling men.

BACKGROUND: Benign prostatic hyperplasia (BPH) and chronic kidney disease are important public health problems in older men. Previous referral-based studies disagree on whether BPH is associated with chronic kidney disease. The objective of this study was to determine the community-based association between clinical measures of BPH and chronic kidney disease. METHODS: A community-based sample of 2115 white men (ages 40-79 years) was randomly selected from the Olmsted County, Minnesota population (55% participation rate) in 1990. A random subsample (N= 476) had a detailed clinical evaluation. This evaluation included a questionnaire with similar queries to the International Prostate Symptom Score (IPSS), peak urinary flow rates (uroflowmeter), postvoid residual urine volume (ultrasound), prostate volume (ultrasound), serum prostate specific antigen (PSA), and serum creatinine. RESULTS: After adjustment for age, hypertension, diabetes, leukocyte esterase positive (possible urinary tract infection), and smoking, chronic kidney disease [serum creatinine > or =133 micromol/L (1.5 mg/dL)] was associated with diminished peak urinary flow rate (<15 mL/sec) by an odds ratio (OR) = 2.96 (95% CI 1.30-7.01), moderate-severe lower urinary tract symptoms (IPSS >7) by an OR = 2.91 (95% CI 1.32-6.62), and chronic urinary retention (postvoid residual >100 mL) by an OR = 2.28 (95% CI 0.66-6.68). There was no association with a prostate volume >30 mL by an OR = 0.56 (95% CI 0.22-1.37) or PSA >1.4 ng/mL by an OR = 1.17 (95% CI 0.47-2.81). CONCLUSION: There was a cross-sectional association between signs and symptoms of bladder outlet obstruction and chronic kidney disease in community-dwelling men. Prostatic enlargement was not associated with chronic kidney disease.

Adult↗

PubMed2005

Agreement between patient reports of cardiovascular disease and patient medical records.

OBJECTIVE: To determine how well patient-reported cardiovascular disease (CVD) and CVD risk factor information agrees with medical record information. METHODS: Information from Patient/Family History (PFH) questionnaires completed between 1996 and 1999 by residents of Olmsted County, Minnesota, aged 20 years and older was compared with information available through the Mayo Clinic medical diagnostic index. Positive and negative agreement values were calculated by comparing agreement between the 2 data sources. Also, with the Mayo Medical Index serving as the criterion standard, sensitivity, specificity, and positive and negative predictive values of questionnaire information were calculated overall and by subgroups of sex, age, and years of education. RESULTS: Questionnaire responses were retrieved for 26,162 patients. Positive agreement values ranged from 31% for report of a medical problem or surgery related to arteries to the head, arms, or legs or the aorta to 78% for high blood pressure. Negative agreement values ranged from 90% for high cholesterol to 98% for medical problem or surgery related to arteries to the head, arms, or legs or the aorta. Sensitivity of questionnaire information ranged from 37% to 73%, whereas positive predictive values ranged from 27% to 86%. Positive agreement, sensitivity, and positive predictive values tended to increase with increasing age of the patient. Specificity and negative predictive values were 87% or greater, and negative agreement, specificity, and negative predictive values decreased with increasing age. CONCLUSION: Positive patient reports of CVD conditions and risk factors are relatively inaccurate. However, negative self-reports of these conditions are unlikely to be noted in the medical record. Further development of the PFH questionnaire is necessary to ensure accurate patient reporting of CVD data.

Adult↗

PubMed2004

Using serum creatinine to estimate glomerular filtration rate: accuracy in good health and in chronic kidney disease.

BACKGROUND: The National Kidney Foundation has advocated the use of the abbreviated Modification of Diet in Renal Disease (MDRD) equation to estimate glomerular filtration rate (GFR) from serum creatinine measurements in clinical laboratories. However, healthy persons were not included in the development of the MDRD equation. OBJECTIVES: To assess the accuracy of the MDRD equation in patients with chronic kidney disease compared with healthy persons and to develop a new equation that uses both patients with chronic kidney disease and healthy persons. DESIGN: Cross-sectional study. SETTING: The Mayo Clinic, a tertiary-care medical center. PARTICIPANTS: Consecutive patients (n = 320) who had an iothalamate clearance test specifically for chronic kidney disease evaluation and consecutive healthy persons (n = 580) who had an iothalamate clearance test specifically for kidney donor evaluation. MEASUREMENTS: Serum creatinine levels, GFR, demographic characteristics, and clinical characteristics were abstracted from the medical record. RESULTS: The MDRD equation underestimated GFR by 6.2% in patients with chronic kidney disease and by 29% in healthy persons. Re-estimated coefficients for serum creatinine and sex were similar to the original MDRD equation in the chronic kidney disease series but not in the healthy series. At the same serum creatinine level, age, and sex, GFR was on average 26% higher in healthy persons than in patients with chronic kidney disease (P < 0.001). A quadratic GFR equation was developed to estimate logarithmic GFR from the following covariates: 1/SCr, 1/SCr2, age, and sex (where SCr = serum creatinine). LIMITATIONS: The new equation was not developed in a general population sample. Elderly and African-American persons were underrepresented. CONCLUSION: The MDRD equation systematically underestimates GFR in healthy persons. A new equation developed with patients who have chronic kidney disease and healthy persons may be a step toward accurately estimating GFR when the diagnosis of chronic kidney disease is unknown.

Adolescent↗

PubMed2004

Serum sex hormones and measures of benign prostatic hyperplasia.

BACKGROUND: Despite biologic plausibility, the associations between sex hormones and measures of benign prostatic hyperplasia (BPH) have not been consistently reported. METHODS: Subjects were randomly selected from the Olmsted County, MN population (n, 320; median age, 60.9 years) and followed biennially since 1990. In 2002, surrogate measures of BPH were assessed from an approximation of the American Urological Association Symptom Index (AUASI), Peak urinary flow rates (Q(max)), and a transrectal ultrasound assessment of prostate volume. Serum levels of prostate specific antigen (PSA), testosterone, bioavailable testosterone, and estradiol were also measured. RESULTS: Bioavailable testosterone levels declined with increasing cross-sectional age from 53.8, 50.2, to 41.2 ng/dl (P = 0.001) in men aged <60, 60-69, and >69 years, respectively, and the estradiol/bioavailable testosterone ratio increased from 0.042, 0.044, to 0.050 (P = 0.04). Among men with bioavailable testosterone above the median, estradiol levels had a dose response relationship with prostate size. Among men with bioavailable testosterone level </= the median, however, there was no association between estradiol level and prostate volume CONCLUSIONS: While cross-sectional, these findings suggest a more complex relationship between sex steroids and prostate volume in older men than simple independent effects.

Adult↗

PubMed2004

Cardiac rehabilitation after myocardial infarction in the community.

OBJECTIVES: The aim of this study was to examine participation in cardiac rehabilitation after myocardial infarction (MI) by age and gender and the association of participation with survival. BACKGROUND: Lesser participation in cardiac rehabilitation has been reported for women and the elderly. METHODS: All incident MIs in Olmsted County were validated. Baseline characteristics and outcomes were ascertained from the medical record. Logistic regression examined the association between participation, age, and gender. Propensity scores were used to examine the association between participation and outcome. RESULTS: Among 1,821 persons with incident MI (58% men, 46% age >70 years), 55% participated in cardiac rehabilitation. Participants were more likely to be men, younger, and have fewer comorbidities (p < 0.01 for all comparisons). After adjustment, women were 55% less likely to participate than men (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.34 to 0.60), and persons 70 years or older were 77% less likely to participate than persons younger than 60 (OR 0.23, 95% CI 0.16 to 0.33). Participants had a lower risk of death and recurrent MI at three years (p < 0.001 and p = 0.049, respectively). The survival benefit associated with participation was stronger in more recent years (relative risk [RR] for 1998 vs. 1982 0.28, 95% CI 0.18 to 0.43; RR for 1990 vs. 1982 0.41, 95% CI 0.33 to 0.52). CONCLUSIONS: Approximately half of the patients participated in cardiac rehabilitation after MI. Participation did not increase over time. Women and elderly persons were less likely to participate, independently of other characteristics. Participation in rehabilitation was independently associated with decreased mortality and recurrent MI, and its protective effect was stronger in more recent years.

Age Factors↗

PubMed2004

Temporal trends in the incidence of coronary disease.

PURPOSE: Mortality due to coronary disease has declined, but the incidence of myocardial infarction has changed little. Whether the incidence of myocardial infarction reflects that of overall coronary disease is unknown. This study was designed to determine whether the incidence of coronary disease has declined over time. METHODS: We ascertained incident cases of overt coronary disease (myocardial infarction, sudden death, angiographically diagnosed coronary disease, unstable angina not identified under other rubrics) between 1979 and 1998, using medical records of patients in Olmsted County, Minnesota. Secular trends were analyzed with Poisson regression. RESULTS: Between 1979 and 1998, there were 5772 incident cases of coronary disease (myocardial infarction: 1991; sudden death: 1056; angiographically diagnosed coronary disease: 2514; unstable angina: 211). The age- and sex-adjusted incidence of myocardial infarction declined 6% during these two decades and 3% in the second decade, whereas the incidence of myocardial infarction and sudden death combined declined 17% in the first two decades and 9% in the second decade. Use of angiography increased and served as a measure of coronary disease incidence in the second decade. During the second decade, trends in the incidence of all coronary diseases paralleled those of myocardial infarction and of myocardial infarction and sudden death combined, declining 9% (P = 0.06). Cases of coronary disease diagnosed angiographically increased during the period studied. CONCLUSION: The trends that we observed suggest that myocardial infarction and sudden death constitute suitable indicators of trends in coronary disease. The decline in incident coronary disease cases supports the hypothesis that the decline in mortality is explained in part by primary prevention and secondary prevention partially mediated by earlier detection.

Age Factors↗

PubMed2004

Trends in heart failure incidence and survival in a community-based population.

CONTEXT: The epidemic of heart failure has yet to be fully investigated, and data on incidence, survival, and sex-specific temporal trends in community-based populations are limited. OBJECTIVE: To test the hypothesis that the incidence of heart failure has declined and survival after heart failure diagnosis has improved over time but that secular trends have diverged by sex. DESIGN, SETTING, AND PARTICIPANTS: Population-based cohort study using the resources of the Rochester Epidemiology Project conducted in Olmsted County, Minnesota. Patients were 4537 Olmsted County residents (57% women; mean [SD] age, 74 [14] years) with a diagnosis of heart failure between 1979 and 2000. Framingham criteria and clinical criteria were used to validate the diagnosis MAIN OUTCOME MEASURES: Incidence of heart failure and survival after heart failure diagnosis. RESULTS: The incidence of heart failure was higher among men (378/100 000 persons; 95% confidence interval [CI], 361-395 for men; 289/100 000 persons; 95% CI, 277-300 for women) and did not change over time among men or women. After a mean follow-up of 4.2 years (range, 0-23.8 years), 3347 deaths occurred, including 1930 among women and 1417 among men. Survival after heart failure diagnosis was worse among men than women (relative risk, 1.33; 95% CI, 1.24-1.43) but overall improved over time (5-year age-adjusted survival, 43% in 1979-1984 vs 52% in 1996-2000, P<.001). However, men and younger persons experienced larger survival gains, contrasting with less or no improvement for women and elderly persons. CONCLUSION: In this community-based cohort, the incidence of heart failure has not declined during 2 decades, but survival after onset of heart failure has increased overall, with less improvement among women and elderly persons.

Age Factors↗

PubMed2004

Plasma brain natriuretic peptide to detect preclinical ventricular systolic or diastolic dysfunction: a community-based study.

BACKGROUND: Preclinical systolic or diastolic dysfunction is associated with increased morbidity and mortality. We postulated that plasma brain natriuretic peptide (BNP) might serve as a biomarker for preclinical ventricular dysfunction (PCVD) but that the discriminatory values for BNP may vary with age and sex. METHODS AND RESULTS: We measured BNP, systolic and diastolic ventricular function, and clinical parameters in 2042 randomly selected residents of Olmsted County, Minn, aged 45 years or older. For preclinical systolic dysfunction, the areas under the receiver operating characteristics curve were higher for those with more severe (0.82 to 0.92) than any (0.51 to 0.74) systolic dysfunction and were similar in men and women and in younger and older persons. For preclinical diastolic dysfunction, the areas under the receiver operating characteristics curve were higher for those with moderate-to-severe (0.74 to 0.79) than any (0.52 to 0.68) diastolic dysfunction and were similar regardless of age or sex. Optimal discriminatory values of BNP varied with age and sex. Considering the prevalence of preclinical systolic or diastolic dysfunction and the predictive characteristics observed, using BNP to screen for PCVD would necessitate echo in 10% to 40% of those screened, with most confirmatory echocardiograms being negative, and would miss 10% to 60% of those affected. CONCLUSIONS: BNP is a suboptimal screening test for PCVD in the population.

Age Factors↗

PubMed2004

Sudden death and recurrent ischemic events after myocardial infarction in the community.

As myocardial infarction (MI) hospital fatalities decline, survivors are candidates for recurrent events. However, little is known about morbidity after MI and how it may have changed over time. The authors examined the incidence of sudden cardiac death and recurrent ischemic events post-MI to test the hypothesis that it has declined over time. MIs were validated by using standardized criteria. Sudden cardiac death and recurrent ischemic events (recurrent MI or unstable angina) were identified through Olmsted County, Minnesota, community medical records and their association with time examined after adjustment for age, sex, and comorbidity. Between 1979 and 1998, 2,277 MIs occurred (57% in men; mean age, 67 (standard deviation, 14) years). After 3 years, the event-free survival rate was 94% (95% confidence interval: 93, 95) for sudden cardiac death and 56% (95% confidence interval: 54, 58) for recurrent ischemic events. Both outcomes were more frequent with older age and greater comorbidity. The temporal decline in both events was of similar magnitude; for an MI occurring in 1998 versus 1979, risk of subsequent recurrent ischemic events or sudden cardiac death declined by 24% (relative risk = 0.76, 95% confidence interval: 0.63, 0.93). Thus, in the community, recurrent ischemic events are frequent post-MI, while sudden cardiac death is less common. Their incidence declined over time, supporting the notion that contemporary treatments effectively improve outcomes after MI.

Aged↗

PubMed2004

Associations between human leukocyte antigen (HLA) alleles and very high levels of measles antibody following vaccination.

Associations between human leukocyte antigen (HLA) genes and very high levels of antibodies (or hyperseroresponsiveness) to measles antigens in a genetically heterogeneous human population are poorly understood. We studied the association between antibody levels after measles vaccination and HLA class I and II alleles among 170 US schoolchildren who received one dose of measles-mumps-rubella II vaccine. Vaccine recipients were divided into two groups: 93 recipients who were seropositive and 77 recipients who were hyperseropositive (the upper 10th percentile of antibody levels of all subjects). Out of all the alleles analyzed, HLA-B(*)7 (odds ratio (OR) 1.9; P = 0.05), DQA1(*)0104 (OR 4.6; P = 0.02) and DPA1(*)0202 (OR 4.8; P = 0.04) alleles were positively associated with hyperseropositivity, whereas HLA-B(*)44 (OR 0.4; P = 0.02), DRB1(*)01 (OR 0.6; P = 0.09), DRB1(*)08 (OR 0.3; P = 0.04), DQB1(*)0301 (OR 0.5; P = 0.04), and DPB1(*)0401 (OR 0.6; P = 0.03) alleles were negatively associated with hyperseropositivity. The alleles B(*)44, DRB1(*)01, DRB1(*)08 and DQA1(*)0104 remained statistically significant after accounting for the effects of other alleles. The results suggest that HLA alleles have important associations with measles antibody hyperseropositivity. These data increase our understanding of measles vaccine-induced immune response and will be useful for future mechanistic work on measles virus antigen processing and presentation in seronegative and hyperseropositive individuals.

Alleles↗

PubMed2004

Androgen receptor gene polymorphisms and increased risk of urologic measures of benign prostatic hyperplasia.

The association between androgen receptor gene polymorphisms and benign prostatic hyperplasia was investigated among 510 men randomly selected from Olmsted County, Minnesota. From 1990 through 2000, lower urinary tract symptom severity was assessed by the American Urological Association Symptom Index (AUASI), and peak urinary flow rate, prostate volume, and serum prostate-specific antigen level were measured. Androgen receptor CAG and GGN genotyping was performed. A CAG repeat length of <21 was associated with an enlarged prostate (hazard ratio (HR) = 1.4, 95% confidence interval (CI): 1.0, 1.9) and a serum prostate-specific antigen level >1.4 ng/ml (HR = 1.5, 95% CI: 1.1, 2.0). A GGN repeat length of <16 was associated with an AUASI >7 (HR = 1.6, 95% CI: 1.1, 2.3) and a serum prostate-specific antigen level >1.4 ng/ml (HR = 1.5, 95% CI: 1.0, 2.3). Having <21 CAG repeats and <16 GGN repeats compared with having neither was associated with an enlarged prostate (HR = 2.5, 95% CI: 1.5, 4.2), a serum prostate-specific antigen level >1.4 ng/ml (HR = 2.8, 95% CI: 1.6, 4.7), a peak flow rate <12 ml/second (HR = 1.9, 95% CI: 1.1, 3.4), and an AUASI >7 (HR = 1.6, 95% CI: 1.0, 2.7). Androgen receptor gene polymorphisms may have a potential role in the pathogenesis of benign prostatic hyperplasia.

Antigens, Neoplasm↗

PubMed2004

A twin study of erectile dysfunction.

BACKGROUND: The extent of genetic influence on erectile dysfunction (ED) is unknown. This study determines the contribution of heredity to ED in a sample of middle-aged men. METHODS: A classical twin study was conducted in the Vietnam Era Twin Registry, a national sample of male-male pairs (mean birth year, 1949) who served on active duty during the Vietnam era (1965-1975). A 1999 male health survey was completed by 890 monozygotic (MZ) and 619 dizygotic (DZ) pairs. The prevalence and heritability of 2 self-report indicators of ED, difficulty in having an erection and in maintaining an erection, are estimated. RESULTS: The prevalence of difficulty in having an erection is 23.3% and in maintaining an erection is 26.7%. Twin correlations for dysfunction in having an erection are 0.35 (95% confidence interval [CI], 0.28-0.41) in MZ and 0.17 (95% CI, 0.09-0.27) in DZ pairs. For dysfunction in maintaining an erection, the twin correlations in MZ and DZ pairs are 0.39 (95% CI, 0.32-0.45) and 0.18 (95% CI, 0.09-0.27), respectively. The estimated heritability of liability for dysfunction in having an erection is 35% and in maintaining an erection is 42%. The heritable influence on ED remained significant after adjustment for ED risk factors. CONCLUSIONS: The present study demonstrates an ED-specific genetic component that is independent of genetic influences from numerous ED risk factors. The results suggest that future molecular genetic studies to identify ED-related polymorphisms are warranted.

Adult↗

PubMed2004

Participation bias in a population-based echocardiography study.

PURPOSE: To compare the characteristics of participants and non-participants in a population-based study of cardiac ventricular function. METHODS: Subjects aged 45 years and older on January 1, 1997 were recruited from a sampling frame of Olmsted County residents from the Rochester Epidemiology Project. Subjects were asked to complete a 17-page questionnaire and participate in a 4-hour clinical examination that included a brief physical examination, echocardiography, spirometry, and an electrocardiogram. With specific IRB approval, the community medical records of participants and non-participants from the first wave of recruitment were examined by trained nurse abstractors to elicit details of past medical history. RESULTS: Of the first 963 persons invited to participate in the study, 488 (51%) completed all phases of the examination. Participation rates were similar among men and women (53% vs. 49%, respectively). By age, participation rates were lowest among persons aged 75 years and older (44.7% and 34.9%) and 45 to 54 years (45.4% and 44.3%) for men and women. Participation rates were not different according to past history of coronary heart disease, congestive heart failure, or other cardiovascular disease. Persons with a history of chronic obstructive pulmonary disease were less likely to participate (19.4% vs. 51%; odds ratio, 0.36; 95% confidence interval, 0.18, 0.76) after adjustment for age, sex, and comorbid conditions. CONCLUSIONS: These results provide some reassurance that participation bias in this study may have little influence on its overall findings, although this cannot be conclusive.

Adult↗

PubMed2004

Gluthatione-S-transferase P1 polymorphism I105V in familial and sporadic prostate cancer.

Several reports suggest that the glutathione-S-transferase (GST) family of enzymes is involved in a variety of cancers, due to their carcinogen-detoxification properties. A polymorphism in codon 105 of the pi variant (GSTP1 I105V), which affects the enzymatic activity of the enzyme, has been linked to the incidence of cancers from different organs. However, the published data in prostate cancer (PCa) is controversial. Some studies report an association with the GSTP1 I105V polymorphism and sporadic PCa, whereas other studies report no association. Recently, one study showed a positive correlation between the GSTP1 I105V polymorphism and familial PCa in a Japanese population. In the present study, we assessed the correlation of the GSTP1 I105V polymorphism with familial and sporadic PCa in an American population. We analyzed DNA samples from 438 patients with familial PCa, 499 patients with sporadic PCa, and 510 controls. We found no significant association between the GSTP1 I105V polymorphism and familial or sporadic PCa when compared to the control group [odds ratio (OR) =1.0 (0.74-1.37); P=0.58]. Moreover, no association was found after stratification for age of diagnosis, Gleason grade, or lymph node involvement [OR =0.84 (0.65-1.09), P=0.37]. These data indicate that there is no associated risk for sporadic or familial PCa in American families containing the GSTP1 I105V polymorphism.

Adult↗

PubMed2004

The contribution of HLA class I antigens in immune status following two doses of rubella vaccination.

The variability of humoral and cellular immune responses modulated by human leukocyte antigen (HLA) genes is a significant factor in the protective effect of rubella vaccines. We performed HLA class I typing in a group of 346 healthy schoolchildren and young adults who previously received two doses of measles-mumps-rubella-II vaccine. Rubella virus-specific humoral (serum antibody) immunity and cell-mediated immunity (lymphocyte proliferation) were assessed. Median values for antibody levels and stimulation indices (SI) were 38.63 IU/ml and 2.29 IU/ml, respectively. The alleles that provided suggestive, but not conclusive, evidence of HLA association with rubella seropositivity were HLA-B*2705 (median, 24.68 IU/ml; p = 0.160), B*4501 (median, 61.22 IU/ml; p = 0.098), Cw*0303 (median, 30.34 IU/ml; p = 0.102) and Cw*0704 (median, 26.58 IU/ml; p = 0.144). These alleles approach, but do not achieve, statistical significance. Of all the alleles analyzed, HLA-B*3503 (median SI, 3.00; p = 0.031) and HLA-Cw*1502 (median SI, 3.19; p = 0.035) were positively associated with lymphoproliferative responses to rubella virus antigens, whereas the HLA-B*3901 (SI, 1.34; p = 0.066) allele was negatively associated. This suggests that class I HLA alleles may have limited associations with humoral and cellular immune responses to rubella vaccine. These data may facilitate our understanding of immune response variation in a genetically outbred heterogeneous population.

Adolescent↗