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Biomedical subjects

A Ostfeld

Publications and source records attributed to A Ostfeld.

16 recordsLinked to original sources
PubMed1992

Influence of dietary fat, apolipoprotein E phenotype, and sex on plasma lipoprotein levels.

BACKGROUND: The "Western" diet, sex, and apolipoprotein (Apo) E polymorphism have been implicated as codeterminants of lipid levels. METHODS AND RESULTS: In a retrospective analysis, we evaluated the combined impact of dietary fat, sex, and Apo E phenotype on lipoprotein levels in 67 subjects fed two contrasting, metabolically controlled diets: one a "Western" diet, with a low polyunsaturated to saturated (P:S) fatty acid ratio and the other a "therapeutic" diet, with a high P:S ratio. The high P:S diet compared with P:S diet exerted a far stronger predictive influence on lipoprotein concentrations than Apo E phenotype, sex, or the latter two factors combined. Apo E phenotype alone was associated with a stepwise increase in low density lipoprotein cholesterol (LDL-C), such that 3/2 less than 3/3 less than 4/3 on either the low or the high P:S diets. On the low P:S diet only, sex was shown to be a significant predictor of high density lipoprotein cholesterol (HDL-C) levels, with women greater than men, and the associated LDL/HDL ratio with men greater than women. On the high P:S diet, women displayed a dramatic fall in HDL-C, effectively raising the LDL/HDL ratio to equivalency with men and obliterating the sex influence seen with the low P:S diet. Controlled for dietary fat, Apo E and sex exerted independent, additive effects on lipoprotein levels on the low P:S diet only. Only the Apo E phenotype remained predictive on the high P:S diet. CONCLUSIONS: Women of the Apo E 3/2 phenotype stand to benefit the least from a high P:S diet because of reduction in the more "protective" HDL-C, whereas men of the 4/3 phenotype showed the greatest improvement in the LDL/HDL ratio.

Adult↗
PubMed1991

Active life expectancy for 10,000 Caucasian men and women in three communities.

Active life expectancies (ALEs) were calculated using increment-decrement life table techniques for 10,000 Caucasian men and women from three geographic areas. This technique is more appropriate than the single decrement model originally used, and resulting ALE was substantially greater among initially independent men and women aged 65 years: from 9.3 for men and 10.6 for women to 11.3 to 13.0 for men and 15.5 to 17.1 for women. These increases may be attributable to factors other than the change of method, however, including the change in time from 1975 to 1982 and the change from one state to three communities. The sex differences suggest that the added years of life that women have enjoyed over men are neither solely added years of vigor nor solely added years of disability, but added years with the same mix of independence/dependence that the shorter-lived males experience. The age patterns suggest that at any age the future presents a relatively constant expectation of the total duration of dependency, and concordantly, as one ages, there is a relatively uniform decrease in the proportion of active life to remaining years.

Activities of Daily Living↗
PubMed1990

Anxiety disorders during acute bereavement: risk and risk factors.

Forty-four percent of bereaved spouses reported at least one type of anxiety disorder during the first year of bereavement in a survey of a representative sample composed of a subgroup (N = 48) assessed 6 months after bereavement and another subgroup (N = 54) assessed 12 months after bereavement. The bereaved spouses experienced 6-month prevalence rates for panic disorder and generalized anxiety disorders that were higher than community prevalence rates for the same metropolitan area (p less than .01). Past personal history of anxiety disorder was an independent risk factor (p less than .05), and anxiety disorders were associated with severe grief (p less than .01) and depression (p less than .05). The large overlap of anxiety disorders with major depression observed in this study indicates that the estimated rates of anxiety disorder are not independent of major depression in most cases and raises questions about whether the anxiety disorders of bereavement are prodromal, concomitant, or residual with respect to major depression.

Adult↗
PubMed1986

Psychological distress, depression and prolactin response in stressed persons.

We examined the relationship of psychological distress to serum prolactin response in 54 persons who had lost a spouse or were threatened with a loss. We found that our two measures of psychological distress, both separation anxiety and depression, were directly correlated with prolactin response during a stressful interview (p less than .05). When we stratified the sample first by depression score and then by separation anxiety, we found a positive correlation between separation anxiety and prolactin response only in the highly depressed half of the sample (r = .32) and a positive correlation between depression and prolactin response only in the highest quartile of intensity for separation anxiety (r = .49, p less than .05). This suggested that both depression and separation anxiety, each in conjunction with high levels of the other but not independently, rendered the individual under stress more physiologically sensitive to distressing challenges such as a stressful interview. Alternatively, it was global distress above a certain threshold that was associated with degree of physiological response.

Anxiety, Separation↗
PubMed1986

The measurement of grief: age and sex variation.

Age and sex variation in the expression of grief were examined using a structured assessment to test clinically based impressions that widowers by comparison with widows and older bereaved persons by comparison with middle-aged counterparts would report distinctive aspects of grief and less intense distress. One hundred and fourteen acutely bereaved spouses were interviewed one month after a loss. The psychological assessment used was designed to measure several dimensions of grief including separation anxiety, numbness-disbelief and depression. Widows reported significantly more numbness-disbelief and depression than widowers but no difference in the intensity of separation anxiety. Contrary to our hypotheses, no attenuation in the intensity of grief was observed among older bereaved spouses, though they reacted to the loss with less emotional numbness and disbelief of the reality than the middle-aged comparison group. Furthermore, they reported no more neurovegetative or illusory symptoms than middle-aged, bereaved spouses. Older widowers experienced more separation anxiety than younger widowers. It seems possible that these differences account, in part, for age and sex variation in the morbidity and mortality of bereavement.

Age Factors↗
PubMed1985

Acute bereavement, threatened loss, ego defenses and adrenocortical function.

In this study of 43 acutely bereaved widows and widowers and a comparison group of 24 nonbereaved married persons who experienced critical illness in a spouse, we found no evidence of higher levels of affective arousal, higher levels of adrenocortical activity, less effective ego defenses, or higher levels of defensive work among bereaved persons by comparison with nonbereaved persons. Furthermore, we failed to observe expected relationships between ego defensive function and adrenocortical activity among either bereaved or nonbereaved persons. These observations are consistent with one previous study of bereaved parents.

Arousal↗
PubMed1979

Use of a self-administered questionnaire for detection of transient cerebral ischemic attacks: I. Survey of elderly persons living in retirement facilities.

A self-administered questionnaire designed to identify people with transient cerebral ischemia (TIA) in large population groups was distributed to approximately 10,000 elderly persons living in public and private retirement facilities in the United States. The population resided in eight cities, and 74% completed the survey. Transient focal neurological symptoms compatible with a diagnosis of TIA within the previous year were reported by 6.4% of the respondents. Uncertain manifestations of TIA, i.e., dizziness, light-headedness, or loss of balance, were noted by an additional 15.4%; the remaining 78.2% had no manifestations of this disorder. A clinical history for TIA was taken by a neurologist in a sample of 1,712 respondents to determine the validity of the questionnaire responses. Thirty (7.1%) of 423 persons presumed by the questionnaire to have TIA met the standard clinical criteria for the diagnosis. An additional 8 cases of TIA were found by the neurologist among the 1,289 interviewed persons presumed by the questionnaire to have uncertain TIA or no evidence of the disorder. The twelve-month period prevalence of TIA was estimated to be 8.2 per 1,000 in the total respondent population and 5.8 per 1,000 among those without a history of prior completed stroke. Despite the high proportion of false-positive neurological symptoms of TIA elicited by the questionnaire, this survey instrument nevertheless screened out for further study the 6% of the population in whom 55% of the TIAs occurred.

Aged↗
PubMed1977

The systemic use of procaine in the treatment of the elderly: a review.

This article is a review and evaluation of the world literature on the systemic use of procaine in the treatment of the aging process and the common chronic diseases of later life. Included are data from 285 articles and books, describing treatment in more than 100,000 patients in the past 25 years. Except for a possible antidepressant effect, there is no convincing evidence that procaine (or Gerovital, of which procaine is the major component) has any value in the treatment of disease in older patients. If procaine has an antidepressant effect, there is some likelihood that this accounts for the reports of decreased complaints referable to the musculoskeletal, cardiovascular, endocrine sexual, gastrointestinal and respiratory systems.

4-Aminobenzoic Acid↗
PubMedDate not supplied

Depressions of bereavement.

The clinical significance of the depressions of bereavement is controversial. Although evidence suggests that most of these depressions remit spontaneously, some of them do require professional attention. Using a trained, non-professional screener, a study to screen for depressions of bereavement at 6 and 12 months after loss of a spouse was performed to determine the rate of depression and its characteristics. The relative value of using a dimensional assessment of depression (20-item Center for Epidemiologic Studies Depression [CES-D] Scale) and a structured diagnostic schedule for depression (Structured Clinical Interview for the DSM [SCID]) as telephone screening measures was evaluated. We found that while the CES-D overestimated, the SCID more precisely reflected the true rate of depression as determined in a subsample. The criterion for depression in this analysis was a diagnostic interview by a psychiatrist using DSM-III criteria and the Hamilton Rating Scale for Depression (HRSD). The study confirmed the existing literature on the high rate of depressions at 6 months (32% of bereaved spouses) and 12 months (27% of bereaved spouses) after a loss. These depressions were more common in widows than widowers. Past personal history (PPH) of depression and family history (FH) of depression were common among bereaved spouses, but did not enhance the risk of depression. Most of these depressions lasted considerably longer than 1 month. Anxiety, restlessness, and psychomotor retardation were prominent; melancholia was occasionally observed; and intense grief was associated with the depression.

Adaptation, Psychological↗
PubMedDate not supplied

An epidemiological review of the mortality of bereavement.

Epidemiological literature revealing excess mortality in the newly widowed is reviewed. The risk varies by age and sex. Younger persons and men are at higher risk. There are manifold specific causes of death characterized by conditions manifest in middle and late life. Cause specificity also varies by sex. Methodological problems in this literature are mitigated by application of varied methodology and replication of basic findings. Socioeconomic status and "social" stress are not well controlled as independent variables. Nevertheless, they probably do not explain the large relative risk of mortality among the bereaved. Pathogenetic mechanisms resulting from a loss are probably twofold: physiologic changes associated with the loss response and behavioral changes that comprise health maintenance or chronic disease management. Because of its important as a health problems, as a fundamental human reaction, and as a research strategy for the basic psychosomatic hypothesis, bereavement is a prime target of investigation.

Adult↗
PubMedDate not supplied

Borderline hypertensives volunteering for follow-up and biofeedback. A preliminary study: locus of control characteristics.

We compared the locus of control scores of the following groups: (1) 19 male borderline hypertensives volunteering for biofeedback treatment; (2) 100 consecutive males who were screened for hypertension; (3) 30 male cancer patients receiving radiation therapy, and (4) the normative data from college students. The biofeedback volunteer group was significantly more internal in locus of control as compared to all other groups. The locus of control of the borderline hypertensives within the screened population did not differ from the normotensives, but the screened population as a whole had a relatively internal locus of control. Our findings imply that the 'internals' may be more attracted to self-control treatments like biofeedback, and data generated from this particular population may have limited generalizability, especially in regard to 'externals'.

Biofeedback, Psychology↗