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Biomedical subjects

D R Labarthe

Publications and source records attributed to D R Labarthe.

88 records · Page 5Linked to original sources
PubMed1976

Excess and deficit lung cancer mortality in three ethnic groups in Texas.

Based on Texas vital statistics for 1969-71, patterns of lung cancer mortality in three ethnic groups are examined. Among males, the risk of lung cancer for Mexican Americans is considerably lower than for Blacks and Anglos for ages under 75 and slightly higher for older ages. Among females, Mexican American exhibit a distinct excess of lung cancer mortality for ages 70 and over and a deficit for younger ages. The excess among Mexican American females is confined mainly to the older foreign-born women and the excess is reduced for ages 45-60 and diminishes for younger immigrants. This suggests that the excess risk among Mexican Americans will completely disappear within a generation and a general deficit pattern will emerge for all ages. The implications of the diminishing excess and the emerging deficit lung cancer mortality among Mexican Americans clearly call for further study in exploring the effect of cultural change on mortality patterns, particularly for cancer.

Adult↗
PubMed1976

Ischemic heart disease in patients with epilepsy.

It has been suggested that patients with epilepsy and particularly those on long-term anticonvulsant medication may have a lower than expected risk of ischemic heart disease. The records of a cohort of patients with epilepsy in Rochester, Minnesota were reviewed to ascertain their rates of occurrence of ischemic heart disease. The results did not show any relative decrease in the incidence or mortality rates due to ischemic heart disease among men or women with epilepsy. The numbers of ischemic heart disease incidence and mortality cases were 25 and 15, respectively, relative to corresponding expected values of 15.0 and 15.7 new and fatal events. The use of anticonvulsant medications did not appear to influence the rates of ischemic heart disease among the patients with epilepsy. Subgroups of the epilepsy patients, by etiology and types of epilepsy, were not found to account for a disproportionate share of the ischemic heart disease. The survivorship of epilepsy patients after the initial manifestations of ischemic heart disease was comparable to that expected among all ischemic heart disease patients.

Adult↗
PubMed1976

The prevalence of hypertension in the United States today.

The simplest response to the question, what is the prevalence of hypertension in the United States today?, is given by a currently popular slogan: 23,000,000 Americans have hypertension. It is clear that the problem is large in scale, but this figure alone is an insufficient guide to many practical issues. The prevalence ratio underlying this estimate is about 15% for adults 18 to 79 years of age. Actual prevalence ratios may vary widely in specific sub-groups of the population and in accordance with differing methods and criteria of ascertainment. For example, the actual numbers of hypertensives in the general population of the US, detectable by two-stage screening, may be closer to 8 or 9 million. On the other hand, the current failure generally of detection of hypertension would suggest that the entire adult population must be screened periodically - and this number is greater than 126 million. The implications of these considerations for undertaking screening and management programmes are discussed briefly.

Adult↗
PubMed1976

New instruments for measuring blood pressure.

The development of the conventional indirect method of blood pressure measurement was essentially complete by 1905, 70 years ago. The method has certain shortcomings, but these can be offset to a large degree by control over conditions of measurement, provision of proper apparatus, and intensive training of observers. Still, there are potential advantages which might be met by an acceptable automated device. An experimental evaluation of five such devices led to rejection of each of them on grounds of inadequate measurement performance, mechanical failures, or both. Only the Random-Zero device (Hawksley) among the instruments tested, gave good performance in comparison with the conventional method and was free of serious mechanical disadvantages. Evaluation of new devices will continue to be of great importance, and proposed guidelines for such studies are reviewed.

Blood Pressure Determination↗
PubMed1975

Rauwolfia derivatives and breast cancer. A case/control study in Olmsted County, Minnesota.

In response to three reports of an association between rauwolfia derivatives and breast cancer, a case/control study was undertaken in Olmsted County, Minnesota. Comparison of a cohort of women with breast cancer to an age-match cohort of women with cholelithiasis failed to show any meaningful differences in the two groups except with respect to a history of hypertension. The rates of use of rauwolfia derivatives by hypertensive cases and controls were identical--which, along with other considerations, leads to the conclusion that an association between the use of rauwolfia derivatives and breast cancer is unlikely.

Age Factors↗
PubMedDate not supplied

Anger expression, body fat, and blood pressure in adolescents: Project HeartBeat!

This study explores the potential influence of growth, body/composition, and sexual maturity on the relation of anger expression and blood pressure in adolescents. Baseline data from Project HeartBeat! (82 boys and 85 girls, 14 years of age) examined the ability of anger expression (STAXI scale) to predict blood pressure, after controlling for the effects of ethnicity (African-American/ non-African-American), height, weight, percentage body fat, and sexual maturity. Blood pressures were unrelated to anger expression in models that included the above developmental variables. However, girls scoring high on healthy anger expression ("anger-control") had significantly lower levels of percentage body fat (P = 0.015) independent of the above factors. The literature suggests that body fat or body mass is often, though not unanimously, associated with unhealthy forms of anger expression in adolescents. Research is required into the biological, social, and behavioral origins of the association between body fat and anger expression. Height and sexual maturity, virtually ignored in this literature, should be included in future research.

Adolescent↗
PubMedDate not supplied

Body circumferences as alternatives to skinfold measures of body fat distribution in children.

The ratios of circumferences (waist/hip, waist/thigh) have been proposed in lieu of skinfold measurements for studies of obesity and body fat distribution in adults. The skinfold method has been used successfully in children to study the growth and development of patterns of body fat distribution, but circumferences have not. We studied the relationship between these two methodologies as indicators of body fat and its anatomical distribution among 365 normal children aged 6-11 years, using canonical correlation analysis. With this method, weighted vectors of four body circumferences on the one hand and five skinfolds on the other are formed in such a way that the correlation between the two sets of variables is maximized. Weights (regression coefficients) are assigned each variable and their strength and sign help us to select the best combination of circumferences which describe a component of centralised obesity. A first canonical correlation was substantial in both boys and girls (0.84) and was independent of age. It appeared to relate to fatness level. A second canonical correlation was low (0.34 in boys, 0.35 in girls) (p less than 0.01). It too was age independent and in both sexes it reflected differences between fat on the trunk and on the lower extremity, and was thus a component of centralised fat distribution. The simple waist/thigh ratio correlated better with this canonical variable (0.67-0.88) than the more commonly used waist/hip ratio (0.45-0.79). The 'best' index of centralised fat in children is therefore, the waist/thigh circumference ratio, the same one that has been suggested for adults.

Adipose Tissue↗
PubMedDate not supplied

Is body fat distribution associated with cardiovascular risk factors in childhood?

The authors studied the association of cardiovascular risk variables with body fat distribution (BFD) in a cross-sectional sample of 743 Texas schoolchildren of both sexes ages 6-14 years. This association is well known in adults and several useful indices of BFD are available. Whether they are applicable to children remains a question of importance for epidemiological investigations in this age group. Canonical correlations between anthropometric (five skinfolds, four circumferences) and risk (blood pressures, cholesterol, pulse) variables ranged from 0.37 to 0.82 depending on sex/age group (p < 0.01). The skinfold vector suggested an association of risk with central fat at most but not all ages. The circumference vectors, on the other hand, suggest that size or fatness, not BFD, was related to risk. Partial correlation and stepwise regression of fatness and BFD indices with cardiovascular risk factors as dependent variables, showed that 'fatness' or 'size' was more clearly associated with risk factors than BFD. The variables most consistently entering the regression were hip circumference and sum of skinfolds. These results contrast with studies of adults or sexually mature adolescents, in which BFD is more clearly related to CV risk variables and the hip circumference is a 'low-risk' variable.

Adipose Tissue↗
PubMedDate not supplied

Reserpine and breast cancer in the Hypertension Detection and Follow-Up Program.

Recent reports on the efficacy of pharmacological management in reducing mortality associated with mild hypertension have enhanced the importance of increasing our knowledge about drug toxicity. The Hypertension Detection and Follow-Up Program (HDFP) provides a convenient setting in which to examine the association reported between reserpine usage and breast cancer. In the intensively treated and followed group (Stepped Care [SC]), the relative breast cancer experience of those who did take reserpine and those who did not was examined. Of 2529 females in SC, 1036 received reserpine, with an average exposure of 1.97 years during 5 years of follow-up. Through extensive investigation, 21 cases of breast cancer were identified. using a life table regression method of analysis to adjust for actual time of reserpine exposure, race, sex, and medication status at entry, and comparing those who took reserpine with those who did not, the author's calculated a risk ratio of 1.28, with a confidence interval of 0.58 to 2.80. Adjustment for a number of other variables known to have relationships to breast cancer did not appreciably change the results. Thus, with certain precautions, the authors conclude that in this setting there is no indication of the recently postulated association of reserpine and the short-term enhancement of breast tumor growth.

Adult↗
PubMedDate not supplied

Training and certification of blood pressure observers.

Accurate, reproducible measurements of blood pressure (BP) were central to the goals and objectives of the Hypertension Detection and Follow-Up Program (HDFP), a multicenter clinical trial on the efficacy of pharmacological treatment of individuals with elevated BP. All potential BP observers with or without previous experience in measuring BP were required to undergo a defined training program and meet set performance criteria to be certified to take HDFP BP. Recertification was required twice a year. Originally an audiotape test was used to measure accuracy of BP readings. This approach was later replaced by a videotape test, which proved more realistic and an equally effective tool for long-term quality control. With this technique of certifications, 75% of the individuals taking the test passed on the first attempt and more than 95% passed with one or two attempts. Although agreement for blinded BP duplicates was generally good, the appearance of sound (systolic BP) was identified with greater reproducibility than was the disappearance (diastolic BP). These recertification procedures were of great value in assuring the continued high quality of our BP data.

Allied Health Personnel↗
PubMedDate not supplied

Total parenteral nutrition-related cholestasis in infants.

An epidemiological study was conducted to estimate the proportion of infants on total parenteral nutrition (TPN) who developed cholestasis and to identify risk factors associated with the development of this disease. Data were abstracted from medical records of 624 infants less than or equal to 30 days of age who were treated with TPN. A case of TPN-related cholestasis was defined as an infant whose serum level of direct bilirubin was greater than or equal to 1.5 mg/dl subsequent to initiation of TPN. Risk factors were assessed using multiple logistic regression analysis. Forty-six of 624 infants in the cohort (7.4%) were classified as having TPN-related cholestasis. The multivariable analysis indicated that cholestasis was associated with intracranial hemorrhage, patent ductus arteriosus, sepsis and gastrointestinal conditions that require surgery. Two distinct processes appear to have occurred: in infants who experienced patent ductus arteriosus or intracranial hemorrhage (conditions associated with hypoxia) where TPN may be the necessary trigger for the development of cholestasis, and in infants with gastrointestinal conditions requiring surgery or sepsis, where cholestasis may develop with or without parenteral infusions.

Birth Weight↗