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Biomedical subjects

C M Beard

Publications and source records attributed to C M Beard.

At least 19 recordsLinked to original sources
PubMed1992

Incidence and natural history of primary systemic amyloidosis in Olmsted County, Minnesota, 1950 through 1989.

No reports of the incidence rates for primary systemic amyloidosis (AL) have come to our attention. Records of all residents of Olmstead County, Minnesota, with a diagnosis of amyloidosis were obtained from the Mayo Clinic and its affiliated hospitals, as well as other medical groups that might have seen local patients for the period January 1, 1950 to December 31, 1989. Twenty-one patients fulfilled the criteria for the diagnosis of AL. The median age was 73.5 years, and 62% were men. In all but one patient the diagnosis was made ante mortem. The clinical data of the 21 patients were similar to those referral patients with AL seen at Mayo Clinic. Immunohistochemical stains were positive for monoclonal light chains in the amyloid deposits in 15 of the 21 cases. In six cases, tissue was not available for immunohistochemical studies. Three of the six patients without immunohistochemical stains had a free monoclonal lambda light chain in the urine, and the other three had a monoclonal serum protein. Immunoelectrophoresis/immunofixation detected a monoclonal (M)-protein in the serum of 16 of 17 patients tested. A monoclonal light chain was found in the urine of 10 of 15 patients. The overall sex- and age-adjusted rate per million person-years was 6.1 from 1950 to 1969 and 10.5 from 1970 to 1989. The similarity of these rates suggests no significant increase over time.

Aged↗
PubMed1992

Interobserver variability in medical record review: an epidemiological study of asthma.

Interobserver variability during the data collection for a large retrospective study of asthma was assessed. After extensive training by three physician investigators, two nurses collected study data from existing medical records using an explicit protocol. At four time intervals, samples of records already abstracted by one nurse were reviewed and re-abstracted by another nurse assigned to the project. The unweighted kappa coefficient was used to evaluate observer reliability. Most of the kappa coefficients were > or = 0.6, suggesting good to excellent agreement. Agreement was highest for demographic, clinical and medication variables, while judgement variables had the lowest kappa coefficients. The well known dependence of kappa on the prevalence of the variable studied was evident in these data. We strongly recommend periodic monitoring of observer reliability in any study using more than one individual to collect data to ensure reliable data collection.

Asthma↗
PubMed1992

Conditions associated with carpal tunnel syndrome.

With use of a comprehensive medical records-linkage system, we identified the comorbid conditions and risk factors in the residents of Rochester, Minnesota, who had a diagnosis of carpal tunnel syndrome during 1961 through 1980. In 43.2% of the 1,016 patients, no associated conditions were found on review of the medical records, whereas associated conditions were documented in 56.8%. The most frequent of these conditions were Colles' fracture, rheumatoid arthritis, hormonal agents or oophorectomy (or both), diabetes mellitus, and, among men, occupations that involved excessive use of the hands. Rheumatoid arthritis, diabetes mellitus, and pregnancy were significantly more frequent among the study patients with carpal tunnel syndrome than in the general population of Rochester, Minnesota. The standardized morbidity ratio was 3.6 for rheumatoid arthritis, 2.3 for diabetes mellitus, and 2.5 for pregnancy. The population attributable risk for pregnancy among women 15 to 44 years old was 7.0%. The standardized morbidity ratio for polymyalgia rheumatica was not significantly increased.

Adolescent↗
PubMed1992

Body mass index and the initial manifestation of coronary heart disease in women aged 40-59 years.

A population-based case-control study was conducted to evaluate body mass as a coronary heart disease (CHD) risk factor among women 40-59 years of age. Cases were women aged 40-59 whose first manifestation of CHD was angina (No. = 133), nonfatal myocardial infarction (No. = 90), and sudden unexpected death (No. = 18) during 1960-1982. Two randomly selected controls were matched on age and time of the initial disease manifestation of the case. The adjusted relative risk for weight and body mass index respectively demonstrated a moderate association with all CHD as well as with angina, but no association with definite CHD (myocardial infarction or sudden unexpected death). To determine if the observed association between body mass index and angina was possibly attributable to differential misclassification bias (i.e. obese women were, in contrast to non-obese women, preferentially labelled as having coronary artery disease) data for angina were stratified by confirmed versus unconfirmed cardiac origin. In the unconfirmed angina analysis, the 75th percentile for weight contrasted with the 25th percentile was associated with a 50% increase in the risk of being labelled as having angina (adjusted odds ratio (OR) = 1.59, 95% confidence interval (CI): 1.11-2.28), while a similar contrast for Quetelet Index was also associated with a nearly 2-fold increase in the risk of being labelled as having angina (adjusted OR = 1.74, 95% CI: 1.18-2.57).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Lack of association between Alzheimer's disease and education, occupation, marital status, or living arrangement.

Using the resources of the Rochester Epidemiology Project, we conducted a case-control study of sociodemographic characteristics using the incidence cohort of patients with Alzheimer's disease (AD). During the conduct of ongoing studies of AD in Rochester, we identified new cases of AD as they occurred during 1975-1979 (N = 241). We selected one age- and sex-matched control from among all registrations for care in this community during the year of onset for each case. There was little difference between cases and controls for educational attainment, marital status, type of dwelling, living arrangement, or occupation. We were unable to confirm low educational level as a risk factor for AD in this population. Future attempts to identify etiologic risk factors for dementing illness should probably move toward other areas of research.

Aged↗
PubMed1992

Incidence of migraine headache: a population-based study in Olmsted County, Minnesota.

To determine the incidence of clinically detected migraine headache in the defined population of Olmsted County, MN, 1979-1981, we screened over 6,400 patient records from several diagnostic rubrics using the unique resources of the Rochester Epidemiology Project for population-based studies. We identified 629 Olmsted County residents who fulfilled the International Headache Society's 1988 criteria for newly diagnosed migraine headache between 1979 and 1981. The overall age-adjusted incidence was 137 per 100,000 person-years for males and 294 per 100,000 person-years for females. The highest incidence in females was among those aged 20 to 24 years (689 per 100,000 person-years), and in males, the highest incidence was among those aged 10 to 14 years (246 per 100,000 person-years). From 1979 to 1981, there was a striking increase in the age-adjusted incidence in those under 45 years of age: the incidence increased 34% in women and 100% for men. This is the first population-based study of migraine incidence across all ages.

Adolescent↗
PubMed1991

Tuberous sclerosis complex in Olmsted County, Minnesota, 1950-1989.

The incidence of tuberous sclerosis complex in Olmsted County, Minnesota, was 0.28 per 100,000 person-years from 1950 through 1989, the point prevalence on December 31, 1989, was 6.9 per 100,000 persons, and the incidence at birth was 6.0 per 100,000 live births. The incidence was 0.13 per 100,000 person-years from 1950 through 1974 and 0.46 per 100,000 person-years from 1975 through 1989. The higher rate of diagnosis during the later period is believed to be due to the use of computed tomography. Of the 12 patients considered in this study, one patient presented with seizures and severe intellectual disability, six patients presented with seizures, three patients presented with multiple facial angiofibroma, and two patients were asymptomatic.

Female↗
PubMed1991

The incidence of Peyronie's disease in Rochester, Minnesota, 1950 through 1984.

Peyronie's disease was diagnosed in 101 male residents of Rochester, Minnesota between 1950 and 1984. Mean patient age at diagnosis was 53 years. The average age-adjusted annual incidence rate of 25.7 and a prevalence rate of 388.6 per 100,000 male population were noted. The steady increase in incidence with time may reflect an increasing tendency to obtain medical help. However, the possibility of a true increase in the incidence rate cannot be ruled out. An effort was made to identify possible risk factors and other disease associations. Rheumatoid arthritis and hypertension were more common among the patients compared to the Rochester population. In contrast, no excess of diabetes mellitus was observed among patients with Peyronie's disease.

Adult↗
PubMed1991

Malignant potential of the cryptorchid testis.

A follow-up study of 224 male patients from Rochester, Minnesota, diagnosed with cryptorchidism during the period from 1935 through 1974 was conducted to assess the frequency of subsequent testicular neoplasms. Age-specific rates for testicular neoplasm in this community were used to estimate an expected number for comparison with that observed. Two malignant testicular neoplasms have occurred in this cohort; thus, the standardized morbidity ratio was 11.4 (95% confidence interval, 1.4 to 41.1). Of the 158 patients born in the community, 11% were known to have birth weights of less than 2,500 g, approximately twice the expected occurrence. Increased risks were also noted for inguinal hernia, hypospadias, Down's syndrome, cleft lip or palate (or both), clubfoot, and congenital heart disease, for which the standardized morbidity ratios were 3.6, 4.7, 17.8, 11.3, 11.7, and 2.7, respectively. The increased risk for malignant neoplasms observed in this cohort of patients with cryptorchidism is consistent with that found in earlier studies.

Abnormalities, Multiple↗
PubMed1991

Psychologic and adaptational difficulties anteceding amyotrophic lateral sclerosis: Rochester, Minnesota, 1925-1987.

Comprehensive medical records of 45 amyotrophic lateral sclerosis (ALS) patients and 90 controls from the same community, matched by age, gender, and period of observation, were reviewed. Three (13%) of 23 men with ALS, 15 (33%) of 46 control men, 10 (45%) of 22 women with ALS, and 19 (43%) of 44 control women had antecedent psychologic or adaptational difficulties. The proportions of long-standing or serious conditions were comparable in all four groups. However, no man in whom ALS developed had a record of mild antecedent difficulties alone, whereas 3 would have been expected (p = 0.024).

Adaptation, Psychological↗
PubMed1991

Incidence and clinical features of glossopharyngeal neuralgia, Rochester, Minnesota, 1945-1984.

The annual crude incidence rate of glossopharyngeal neuralgia per 100,000 population in Rochester, Minn., for 1945 through 1984, was 0.7 for both sexes combined, suggesting that glossopharyngeal neuralgia is a rare disease. There were no significant differences between the sexes (p greater than 0.10) in the overall age-adjusted (to the total 1980 US population) rates: 1.1 for men and 0.5 for women. Overall age-specific crude rates increased slightly with age. Our results and conclusions, achieved by comparing our data with a large referral study at Mayo Clinic, suggest that glossopharyngeal neuralgia is generally a mild disease, since mild attacks are not uncommon, the average annual recurrence rate for a second episode is low (3.6%), and only one fourth of the cases had to have surgery for relief of symptoms. Bilaterality is not uncommon; it was observed in one fourth of the patients, all of whom had mild disease.

Adult↗
PubMed1991

Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: similarities and differences, Rochester, Minnesota, 1945-1984.

A comparison of epidemiological and clinical features of trigeminal neuralgia (TN) and glossopharyngeal neuralgia (GN) in Rochester, Minn., reveals several differences. The overall age- and sex-adjusted annual incidence rates were significantly higher for TN than for GN (4.7 vs. 0.8 per 100,000 population). The TN:GN ratio was increased for both men and women and was 5.9:1 for both sexes combined. This ratio is greater than reported in previous non-population-based studies. GN is a milder disease than TN, as indicated by the number of episodes, treatment, and characterization of pain. The right side is affected more often with TN than with GN. Bilaterality was noted less often in TN than in GN cases.

Adult↗
PubMed1991

A population-based study of migraine headaches in Olmsted County, Minnesota. Case ascertainment and classification.

Using the unique resources of the Rochester Epidemiology Project for population-based studies, we identified 629 Olmsted County, Minn., residents who fulfilled the 1988 International Headache Society criteria for newly diagnosed migraine over a 3-year period. Over 6,400 patient records from several diagnostic rubrics were screened; a substantial proportion of cases had been 'signed-out' to diagnoses other than 'migraine headache'. Medical records were reviewed by two trained nurses who abstracted supporting data for two neurologists. The neurologists determined whether each case met eligibility requirements and assigned a headache diagnosis by consensus. The diagnostic criteria offered some flexibility and were adapted to retrospective record-based research. Most records contained enough information to effectively classify the headache, although information on the frequency and duration of attacks proved to be problematic. A validation re-abstraction of a 10% sample of cases was undertaken with acceptable reproducibility of symptoms and diagnosis. Our study shows that migraine headache can be studied retrospectively through existing detailed medical records.

Headache↗
PubMed1991

50-year trends in the incidence of anorexia nervosa in Rochester, Minn.: a population-based study.

OBJECTIVE: The aim of the study was to determine incidence and prevalence rates and long-term trends in incidence of anorexia nervosa by identifying all persons residing in the community of Rochester, Minn., during the 50-year period 1935 through 1984 who had the disorder. METHOD: From a community-based epidemiologic resource, 13,559 medical records with diagnoses of amenorrhea, starvation, weight loss, anorexia nervosa, or other conditions were screened to identify true cases of anorexia nervosa determined by using standard diagnostic criteria. RESULTS: One hundred eighty-one residents (166 female and 15 male) fulfilled the diagnostic criteria for anorexia nervosa; these were the incidence cases. Due to a quadratic trend in the rates for girls 10-19 years old, the incidence rate among female residents fell from 16.6 per 100,000 person-years in the 1935-1939 period to a low of 7.0 in 1950-1954 and increased to 26.3 in 1980-1984. The incidence rates for women 20 years old and older and for males remained constant. For females 15-24 years old, there was a linear increase. The overall age-adjusted incidence rate per 100,000 person-years was 14.6 for females and 1.8 for males. The prevalence rate per 100,000 population was 269.9 for females and 22.5 for males. CONCLUSIONS: Anorexia nervosa is more common than previously recognized. Among girls 15-19 years old it is a very common chronic illness. Its incidence has increased among females 15-24 years old but not among older women or among males.

Adolescent↗
PubMed1991

The association between Alzheimer's disease and thyroid disease in Rochester, Minnesota.

To determine whether an association exists between Alzheimer's disease (AD) and thyroid disease, we carried out two studies in the population of Rochester, Minnesota. We reviewed medical records of a cohort of 198 women with histologically confirmed Hashimoto's thyroiditis (1935 to 1974) for evidence of subsequent dementia, applying the criteria used for dementia in a previous determination of incidence and prevalence rates in this population. From a total of 4,197 person-years of follow-up, eight cases of AD were diagnosed, whereas the expected number was 5.8. The standardized morbidity ratio was 1.37, which failed to reach statistical significance. The second study was a retrospective case-control comparison that sought any relationship between AD and all thyroid disorders, using a previously identified (1960 to 1979) AD cohort (N = 646) and their age- and sex-matched controls. For myxedema there was a positive association for AD without significance, whereas in Graves' disease there was a significant negative association for AD.

Adolescent↗
PubMed1991

Is the prevalence of dementia changing?

We compared the point prevalence rates of dementing illnesses in the population of Rochester, Minnesota, on January 1, 1980, with the previously published rates of January 1, 1975, by using extensive health care records available from all sources of care in the community, in order to identify and classify cases with standard diagnostic criteria derived from DSM-III. The overall age- and sex-adjusted prevalence rate per 100,000 population for dementia on January 1, 1980, was 402.5 compared with 388.4 on January 1, 1975; for Alzheimer's disease it was 259.8 in 1980 and 259.5 in 1975. The stability of the rates suggests no change in the incidence and mortality associated with these conditions. The prevalence rates for Rochester, Minnesota, are similar to many other rates estimated in other North American communities, but they differ from two other population-based estimates from East Boston and California. Case definitions and methods of assessment probably account for the differences in estimated prevalence.

Adult↗
PubMed1991

Clinical risk factors for Alzheimer's disease: a population-based case-control study.

Using information on clinical risk factors provided through the medical record linkage system of the Rochester Epidemiology Project, we conducted a population-based case-control study of Alzheimer's disease (AD). During the period 1960 to 1974, we identified 415 newly diagnosed cases of AD among residents of Rochester, Minnesota, and matched one community control to each case based on age, sex, and duration of community medical record. We estimated odds ratios using conditional logistic regression for several potential clinical risk factors of AD. Among more than 20 clinical risk factors that were evaluated, the only statistically significant findings were for episodic depression, personality disorder, and hypertension.

Alzheimer Disease↗