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Biomedical subjects

Daniel Eisenberg

Publications and source records attributed to Daniel Eisenberg.

15 recordsLinked to original sources
PubMed2006

Neuropsychological functioning in opiate-dependent subjects receiving and following methadone maintenance treatment.

OBJECTIVE: An accumulating body of research suggests that former heroin abusers in methadone maintenance therapy (MMT) exhibit deficits in cognitive function. Whether these deficits are present in former methadone maintained patients following discontinuation of MMT is unknown. This study tests the hypothesis that former heroin users who have detoxified from methadone maintenance therapy and are drug-free have less pronounced cognitive impairment than patients continuing long-term MMT. METHOD: A series of neuropsychological tests were administered to three groups of subjects: 29 former heroin addicts receiving methadone maintenance treatment, 27 former heroin addicts withdrawn from all opiates, and 29 healthy controls without a history of drug dependence. Testing included Wechsler Adult Intelligence Scale-Revised Vocabulary Test, the Stroop Color-Word Test, the Controlled Oral Word Association Test, the Benton Visual Retention Test, and a Substance Use Inventory. FINDINGS: Both methadone-maintained and abstinent subject groups performed worse than controls on tasks that measured verbal function, visual-spatial analysis and memory, and resistance to distractibility. Abstinent subjects performed worse than their methadone maintained counterparts on tests measuring visual memory and construct formation. Cognitive impairment did not correlate with any index of drug use. CONCLUSIONS: We confirmed previous findings of neuropsychological impairment in long-term MMT recipients. Both patients receiving MMT and former heroin users in prolonged abstinence exhibited a similar degree of cognitive impairment. Cognitive dysfunction in patients receiving methadone maintenance may not resolve following methadone detoxification.

Adult↗
PubMed2006

Estimating the effect of smoking cessation on weight gain: an instrumental variable approach.

OBJECTIVE: To propose and test a method that produces an unbiased estimate of the average effect of smoking cessation on weight gain. Previous estimates may be biased due to unobservable differences in attributes of quitters and continuing smokers. An accurate estimate of weight gain due to cessation is important for policymakers, health managers, clinicians, consumers, and developers of smoking cessation aids. STUDY SETTING: Our analysis consisted of an instrumental variables (IVs) approach in which treatment assignment in randomized smoking cessation trials served as a random source of variation in probability of quitting. DATA COLLECTION: We searched the medical literature for previously conducted smoking cessation trials that contained data suitable for our reanalysis. PRINCIPAL FINDINGS: We identified one trial for our reanalysis, the Lung Health Study, a randomized smoking cessation trial with 5,887 smokers aged 35-60 from 1986 to 1994 in several sites across the United States. In our IV reanalysis, we estimated a 9.7 kg weight gain over 5 years due to cessation, as compared with the conventional estimate of 5.3 kg. CONCLUSIONS: The true effect of smoking cessation on weight gain may be larger than previously estimated. This result indicates the importance of fully understanding the possible weight effects of cessation and underscores the need to accompany cessation programs with weight management interventions. The result, however, does not overturn the conclusion that the net health benefits of quitting are positive and very large. The application of the IV technique we propose is likely to be useful in a variety of contexts in which one is interested in the effect of one health condition on another.

Adult↗
PubMed2006

Who receives a diagnosis of attention-deficit/ hyperactivity disorder in the United States elementary school population?

OBJECTIVE: To investigate factors that are associated with the probability of attention-deficit/hyperactivity disorder (ADHD) diagnosis among U.S. elementary school children, including child, family, school, and policy factors. METHODS: Logistic regression was used to estimate relative risks associated with independent variables using a nationally representative sample of 9278 children in the 2002 follow-up of the Early Childhood Longitudinal Survey-Kindergarten Cohort. Most children in the sample were in third grade at this point. Previous ADHD diagnoses by professionals were reported by parent respondents. RESULTS: A total of 5.44% of children were reported to have received an ADHD diagnosis. Girls, black children, and Hispanic children were less likely to have the diagnosis even after controlling for other characteristics. Living with one's biological father was negatively associated with ADHD diagnosis. We also found regional variation in diagnosis with the western region of the United States having significantly lower instances of ADHD cases. Higher diagnosis rates were associated with having an older teacher, and lower rates were associated with having a white teacher, relative to a nonwhite teacher. In schools that were subject to stricter state-level performance accountability laws, we found higher odds of ADHD diagnoses, but we found no differences associated with larger class sizes or the presence of state laws that restrict school personnel from discussing ADHD treatment options with parents. CONCLUSIONS: ADHD diagnosis is likely to be influenced by a child's social and school environment as well as exogenous child characteristics. Concerns that increased pressures for school performance are associated with increased ADHD diagnoses may be justified.

Attention Deficit Disorder with Hyperactivity↗
PubMed2005

Effects of snowfalls on motor vehicle collisions, injuries, and fatalities.

OBJECTIVES: We estimated the effects of snowfalls on US traffic crash rates between 1975 and 2000. METHODS: We linked all recorded fatal crashes (1.4 million) for the 48 contiguous states from 1975 through 2000 to daily state weather data. For a subsample including 17 states during the 1990s, we also linked all recorded property-damage-only crashes (22.9 million) and nonfatal-injury crashes (13.5 million) to daily weather data. Employing negative binomial regressions, we investigated the effects of snowfall on crash counts. Fixed effects and other controls were included to address potential confounders. RESULTS: Snow days had fewer fatal crashes than dry days (incidence rate ratio [IRR] = 0.93; 95% confidence interval [CI] = 0.90, 0.97), but more nonfatal-injury crashes (IRR = 1.23; 95% CI = 1.18, 1.29) and property-damage-only crashes (IRR=1.45; 95% CI=1.38, 1.52). The first snowy day of the year was substantially more dangerous than other snow days in terms of fatalities (IRR = 1.14; 95% CI=1.08, 1.21), particularly for elderly drivers (IRR=1.34; 95% CI=1.23, 1.50). CONCLUSIONS: The toll of snow-related crashes is substantial. Our results may help estimate the potential benefits of safety innovations currently proposed by meteorology and traffic safety experts.

Accidents, Traffic↗
PubMed2005

Soluble intercellular adhesion molecule-1 and E-selectin as markers of disease activity and endothelial activation in juvenile idiopathic arthritis.

OBJECTIVE: To determine whether soluble forms of the adhesion molecules intercellular adhesion molecule-1 (ICAM-1) and E-selectin correlate with clinical measures or other markers of endothelial activation in children with juvenile idiopathic arthritis (JIA) over time. METHODS: A total of 28 children with JIA were studied every 3 months over 2 years. At each interval, serum was tested for soluble (s)ICAM-1 and sE-selectin, plasma for fibrin d-dimer and von Willebrand factor (vWF), and the following clinical variables were recorded: erythrocyte sedimentation rate (ESR), physician and parent global assessments, swollen and limited joint counts, and functional assessment by Childhood Health Assessment Questionnaire. Concentrations of the adhesion molecules were also determined once in 30 age matched healthy children. RESULTS: Among all JIA subtypes, baseline sICAM-1 was elevated compared to controls; sE-selectin was higher in patients with systemic disease compared to other subtypes and controls. sE-selectin correlated with ESR, but there were no other correlations between concentrations of either adhesion molecule or any other clinical variables or vWF antigen. sICAM-1 was higher in those with elevated compared to normal d-dimer. There were no differences between mean sICAM-1 and sE-selectin before or during disease flare or improvement periods, except for an increase in sICAM-1 with flares in patients with systemic disease. CONCLUSION: sICAM-1 is elevated in children with active JIA. sE-selectin is only elevated in children with active systemic disease. Although some relationships were found between the adhesion molecules and other variables, they did not correlate with most variables, and did not parallel the disease course. Thus, we cannot recommend the routine use of these molecules as clinical biomarkers of disease activity. This study confirms that endothelial activation is key to the pathogenesis of JIA, especially in the systemic subtype.

Adolescent↗
PubMed2004

The mixed effects of precipitation on traffic crashes.

PURPOSE: This paper investigates the relationship between precipitation and traffic crashes in the US during the period 1975-2000. Traffic crashes represent the leading cause of death and injury for young adults in the US, and the ninth leading cause of death for the overall population. Prior studies have found that precipitation raises the risk of traffic crashes significantly. METHODS: A negative binomial regression approach is employed. Two different units of analysis are examined: state-months and state-days. The sample includes all 48 contiguous states. RESULTS: A surprising negative and significant relationship between monthly precipitation and monthly fatal crashes is found. However, in the daily level analysis, a strong positive relationship is estimated, as in prior studies. The source of the contrasting results appears to be a substantial negative lagged effect of precipitation across days within a state-month. In other words, if it rained a lot yesterday, then on average, today there are fewer crashes. Additional analysis shows that the risk imposed by precipitation increases dramatically as the time since last precipitation increases. For example, 1cm of precipitation increases the fatal crash rate for a state-day by about 3% if exactly 2 days have passed since the last precipitation and by about 9% if more than 20 days have passed. This basic pattern holds for non-fatal crashes as well. CONCLUSIONS: The lagged effects of precipitation across days may be explained by the clearing of oil that accumulates on roads during dry periods or by the conditioning of people to drive more safely in wet conditions. Either way, policy interventions that prepare drivers more adequately for the risks of precipitation following dry periods are likely to be beneficial.

Accidents, Traffic↗