PubMed Health⌕ Search

Biomedical subjects

D Reed

Publications and source records attributed to D Reed.

At least 127 records · Page 7Linked to original sources
PubMed1985

The significance of hydronephrosis after aortofemoral reconstruction.

Hydronephrosis due to ureteral obstruction is a rarely reported complication of aortic bypass grafting. Patients who had undergone aortic reconstruction were screened using serial real-time ultrasound examination to detect ureteral obstruction. The clinical course and incidence of graft complications, renal impairment, amputation, and death were determined for hydronephrotic patients and compared with the incidence of similar complications in a control group. Hydronephrotic patients had an extremely high incidence of graft infection, anastomotic aneurysm, graft thrombosis, and amputation. Obstructed ureters were at high risk for intraoperative injury during removal of infected aortic grafts. A subgroup of hydronephrotic patients who developed multiple anastomotic aneurysms without graft infection was identified. Hydronephrosis was frequently silent, and detection required active investigation. After aortic reconstruction, routine screening with real-time ultrasound examination appears warranted to identify a high-risk subset of patients.

Aged↗
PubMed1985

The type A behavior pattern and coronary heart disease among Japanese men in Hawaii.

This is a study of the association of Type A behavior with the prevalence and 8-year incidence of coronary heart disease (CHD) among 2187 Japanese men in the Honolulu Heart Program cohort. Type A behavior was determined by the Jenkins Activity Survey questionnaire in 1970. The prevalence rate of total CHD was significantly associated with Type A behavior, and this association was independent of other major risk factors in multivariate analyses. With the incidence data, however, there was no significant association of any clinical type of CHD with Type A behavior. Examination of the relationship of Type A behavior to other risk factors showed significant associations with serum cholesterol, obesity, physical inactivity, and alcohol consumption. Pathologic findings among 48 men who died showed no association of Type A behavior with microscopic evidence of myocardial infarction or with grades of atherosclerosis in the coronary arteries and aortas.

Acculturation↗
PubMed1985

Biological and social predictors of health in an aging cohort.

A cohort of over 5000 men of Japanese ancestry, aged 46-69 and free of chronic disease at entry examination were studied for factors associated with remaining free of major chronic diseases during a 12 yr followup period. Over 1600 disease-free men were compared with 3400 individuals who developed coronary heart disease (CHD), stroke, cancer or a variety of other conditions. From more than 30 variables examined in multivariate analyses, blood pressure, obesity, cigarette smoking, alcohol consumption, serum glucose, uric acid and triglyceride, were inversely associated with staying healthy while forced vital capacity and years spent in Japan were directly associated with health. Of these nine variables, blood pressure was the strongest discriminator between healthy status and all categories of disease, while cigarette smoking and alcohol consumption were the next most important factors. This study suggests that the use of individuals who remain free of disease as a "standard" for health can facilitate the evaluation of risk factors for both total illness and a broad range of specific chronic diseases in a single population.

Aged↗
PubMed1985

The relationship of dietary fat and cholesterol to mortality in 10 years: the Honolulu Heart Program.

This report examines the relationship of dietary fat and dietary cholesterol to mortality during a 10-year surveillance of a cohort of men of Japanese descent residing in Hawaii. The consumption of dietary fat (measured in grams) is related inversely and significantly to total mortality. No significant relationships exist between grams of dietary fat and any of the specific causes of death examined. No significant relationships are found between dietary saturated fatty acids (SFA, measured in grams) or dietary cholesterol (measured in milligrams) and any of the specific causes of death examined. In contrast, percentage of calories as fat is related inversely not only to total mortality, but to cancer mortality and to stroke mortality; and it is related directly to coronary heart disease (CHD) mortality. Percentage of calories as SFA is related inversely to cancer mortality and to stroke mortality, and it is related directly to CHD mortality. Only the relationship to stroke mortality remains significant in multivariate analysis if calories from alcohol are excluded from the computation. Dietary cholesterol per 1000 calories is related directly to CHD mortality. While these data provide support for the diet-heart hypothesis, they also suggest that men with low fat intakes have a higher total mortality rate than men with higher fat intakes. This increased risk, due to an excess risk of death from stroke and cancer, indicates that there is no overall beneficial effect from a low fat diet in this cohort.

Aged↗
PubMed1985

Does antacid prophylaxis prevent upper gastrointestinal bleeding in critically ill patients?

Sixty-five surgical ICU patients at high risk of developing acute erosive gastritis and bleeding received prophylactic antacid treatment to maintain a gastric pH of at least 5.0. A similar control group of 61 patients received no specific prophylaxis. All patients in both groups developed microscopic bleeding; however, microscopic bleeding did not influence outcome. In the control group, eight (13.1%) patients developed moderate visible bleeding, as compared to seven (10.8%) patients in the antacid group, an insignificant difference. A single patient in the control group developed severe GI bleeding due to acute erosive gastritis. Antacid prophylaxis did not prevent macroscopic bleeding and there was no correlation between the number of risk factors in individual patients and the rate of upper GI bleeding. We conclude that antacid is not required to prevent upper GI bleeding in high-risk critically ill patients.

Adolescent↗
PubMed1985

Brain concentrations of cocaine and benzoylecgonine in fatal cases.

Since cocaine in blood rapidly hydrolyzes to benzoylecgonine, cocaine concentrations determined in postmortem blood may not reflect the presence or concentration of cocaine in the body at the time of death. The interpretative value of the determination of cocaine and benzoylecgonine in brain tissue was investigated. Cocaine and benzoylecgonine were quantitated by coextraction and formation of the propyl derivative of benzoylecgonine followed by selected ion monitoring gas chromatography/mass spectrometry (GC/MS) using electron ion impact ionization. Cocaine and benzoylecgonine were found to be evenly distributed throughout the brain. Cocaine and benzoylecgonine concentrations were stable in frozen brain tissue (-4 degrees C) on reanalysis after 1 to 3 months of storage, and in refrigerated tissue (10 degrees C) after 30 days of storage. Blood, brain, and liver concentrations of cocaine and benzoylecgonine in 37 cocaine overdose cases and 46 cases in which cocaine was incidental to the cause of death were reviewed. The ratios of cocaine/benzoylecgonine in the toxic cases (brain mean 14.7 and blood mean 0.64) were clearly different from those found in the incidental cases (brain mean 0.87 and blood mean 0.27). The brain/blood ratios of cocaine and benzoylecgonine concentrations generally were characteristic of the time elapsed since cocaine dosing. In cocaine overdose cases, the mean ratio was 9.6 for cocaine and 0.36 for benzoylecgonine. These are within the range found in animal studies for brain/blood ratios of cocaine and benzoylecgonine 0.5 to 2 h after cocaine administration. In incidental cases, the brain/blood ratios were mean 2.5 for cocaine and 1.4 for benzoylecgonine.(ABSTRACT TRUNCATED AT 250 WORDS)

Biotransformation↗
PubMed1984

The results of logistic analyses when the variables are highly correlated: an empirical example using diet and CHD incidence.

We provide an example which includes highly correlated variables in multivariate logistic analyses relating four nutrients to the incidence of coronary heart disease in 10 years for over 7000 men. Paradoxical results occur for both the inferences to be drawn and variable selection. Different models exist which show that any particular variable both is and is not related significantly to coronary heart disease incidence, and step-up and step-down variable selection algorithms provide drastically different results.

Coronary Disease↗
PubMed1984

Psychosocial processes and general susceptibility to chronic disease.

The concept of general susceptibility to disease has developed as a unifying explanation for the findings that a variety of diseases are associated with certain social and cultural situations. This hypothesis was tested in a prospective study of 4251 men of Japanese ancestry in Hawaii who answered a psychosocial questionnaire in 1971. The seven-year incidence rates of coronary heart disease, stroke, cancer, and all deaths during the period December 1971-January 1979 were analyzed for association with individual questions and five summary scores measuring geographic and generational mobility, sociocultural and spousal inconsistency, and social networks. Among all questions and summary scores measuring mobility and inconsistency, there was only one statistically significant association with any disease, and this association was in the opposite direction to that predicted by the hypothesis. The measures of social networks were not associated with either the incidence of stroke, cancer, or all diseases combined, but were associated with coronary heart disease, as reported in detail earlier. The authors examined the joint interaction of the postulated stressful processes of mobility and inconsistency with the protective effects of social networks, with special attention to the men in the highest levels of mobility and inconsistency. They found no significant associations, and thus there was no support for the hypothesis that social networks are especially protective among persons in the highest levels of mobility and inconsistency. The inclusion of known health hazards, cigarette smoking, and high systolic blood pressure levels did not alter these findings.

Aged↗
PubMed1984

Levels of urinary cathepsin B-like substance in patients with gynecologic malignancy.

Because certain proteolytic enzymes are thought to be released by malignant cells, we have measured the activity of cathepsin B in the urine samples of 57 patients with gynecologic malignancies and 60 disease-free controls. A unit (U) of enzyme activity is the release of one n-mol of 7-amino-4-fluoromethylcoumarin (AFC) from BZ-val-lys-lys-arg-MNA min-1 ml-1. Units of activity in the malignant group (10.6 +/- 9.8) differed significantly (p less than 0.0001) from controls (2.8 +/- 3.3). Although enzyme activity in both groups correlated with increasing age, the difference between those subjects with malignancies and those with none remained significant (p = 0.049) by analysis of covariance after adjusting for age. There was no correlation between titers and the race or weight of the subjects in either group. Enzyme activity of subjects with malignant disease correlated (p = 0.003) with the clinical stage of disease. Optimum sensitivity and specificity as determined by Receiver Operator Characteristic Analysis with an upper normal level of 5 U were 84.2% and 86.7%, respectively. Our findings suggest that measurement of urinary cathepsin B might be useful in detecting and managing patients with gynecologic tumors.

Adult↗
PubMed1984

Statistical association between cancer incidence and major-cause mortality, and estimated residential exposure to air emissions from petroleum and chemical plants.

An ecologic study design was used to investigate the relationship between exposure to air emissions produced by the petroleum and chemical industries, and average annual cancer incidence and major cause mortality rates among whites in Contra Costa County, California. Estimates for the exposure to major industrial sources of sulfur dioxide, hydrocarbons and oxides of nitrogen were used to subdivide the county by level of exposure to petroleum refinery and chemical plant emissions. Cancer incidence and major cause mortality rates were then calculated for whites in each of the exposure areas. In both males and females, residential exposure to petroleum and chemical air emissions was associated with an increased incidence of cancer of the buccal cavity and pharynx. In males, age-adjusted incidence rates for cancers of the stomach, lung, prostate and kidney and urinary organs were also associated with petroleum and chemical plant air emission exposures. In both sexes, we found a strong positive association between degree of residential exposure and death rates from cardiovascular disease and cancer, and a less strong positive association between exposure and death rates from cerebrovascular disease. There was also a positive association in men for deaths from cirrhosis of the liver. Although these observed associations occurred across areas of similar socioeconomic and broad occupational class, confounding variables and the "ecologic fallacy" must be considered as possible explanations. In particular, the stronger findings in men suggest an occupational explanation of the cancer incidence trends, and the effect observed in cirrhosis mortality suggests that lifestyle variables such as alcohol consumption were not adequately controlled for. While the public health implications of our findings remain unclear, the evidence presented is sufficient to warrant follow-up studies based on individual data in which possible biases can be more readily controlled.

Air Pollutants↗
PubMed1983

Trends of coronary heart disease among men of Japanese ancestry in Hawaii.

The 15-year prospective study of cardiovascular disease among a cohort of Japanese men in Hawaii provided an opportunity to examine the temporal trends of coronary heart disease (CHD) incidence and mortality rates and to compare them with Hawaii State CHD mortality rates. The State mortality records showed a decline in CHD mortality from 1968 to 1978 which was similar to the national trends. For more than 11,000 men of Japanese ancestry under surveillance, there was no evidence of declining rates for either CHD deaths or for total CHD incidence. There was also no change in case-fatality rates during this time. An explanation for these differences could not be provided but there was a suggestion that it involved changes in classification of some groups of cardiovascular disease and stroke.

Adult↗