Biomedical subjects

K A Sobocinski

Publications and source records attributed to K A Sobocinski.

52 records · Page 3Linked to original sources

PubMed1989

Cigarette smoking and non-fatal myocardial infarction in women: is the relation independent of coronary artery disease?

The relation of cigarette smoking to both coronary disease and non-fatal myocardial infarction was examined in a cross sectional study of 1053 women who underwent coronary arteriography. As compared with the 489 women who had never smoked cigarettes, ever-smokers (mean duration of smoking, 25 years) were 1.6 times as likely to have significant stenotic disease and were 1.9 times as likely to have suffered a myocardial infarction. These associations were strongest in women under 50 years of age, with odds ratios of 3.5 for coronary artery disease and 4.5 for myocardial infarction. Although the extent of stenotic disease and prior myocardial infarction were strongly associated, women who smoked cigarettes remained at increased risk of a myocardial infarction even after their increased coronary artery disease had been taken into account. For example, heavy smokers (greater than 30 pack-years) were 2.3 times as likely to have had a myocardial infarction as were non-smokers; controlling for the extent of stenotic disease (in addition to age and other risk factors) reduced the estimated relative risk to only 1.9. Stratified analyses showed that this increased risk for clinical disease among smokers was evident at all levels of occlusion, even among women with minimal stenotic disease. These results, collected at the time of arteriography, suggest that non-atherogenic mechanisms may be important in the aetiology of myocardial infarction among women who smoke cigarettes.

Coronary Artery Disease↗

PubMed1989

A survey of sued and nonsued physicians and suing patients.

To systematically assess the impact of malpractice litigation on the doctor-patient relationship and to collect data that might suggest effective tort reform, we surveyed 642 sued physicians, nonsued physicians, and suing patients in Wisconsin. Parallel forms of survey instruments obtained information regarding changes in physicians' practices, changes in attitudes toward patients or physicians, and changes in physical and emotional well-being as a result of malpractice litigation or the threat of the same. In addition, opinions regarding causes and deterrents of malpractice litigation were obtained. Results suggested that claims or threats of malpractice suits had a negative impact on physicians' practices and emotional well-being; that this negative impact was more pronounced when the sued physician had been more personally involved with his patient prior to the malpractice claim; and that suing patients' and sued physicians' understanding of their relationship before the malpractice claim significantly differed. All respondents viewed improved physician-patient communication as the most effective method of preventing malpractice claims. Informal, alternative dispute resolution mechanisms in hospitals and clinics and improved peer review may decrease litigation and its deleterious effects.

Adult↗

PubMed1988

Black/white differences in risk factors for arteriographically documented coronary artery disease in men.

Although the leading cause of death among black men in the United States is coronary artery disease (CAD), risk factors have not been well documented in black populations. Therefore, possible racial differences in the relation of several characteristics to the extent of CAD were assessed in 4,722 white and 169 black men who underwent arteriography. Associations between an occlusion score (ranging from 0 to 300), reflecting the severity of CAD, and levels of total and high-density lipoprotein (HDL) cholesterol, triglycerides, cigarette smoking, alcohol intake, relative weight, systemic hypertension and diabetes mellitus were examined. Most risk factors were significantly related to the extent of CAD in both races, but lipid levels showed stronger associations with CAD among blacks: correlations between CAD and total cholesterol were 0.16 (whites) vs 0.29 (blacks) and associations with HDL cholesterol were -0.22 (whites) vs -0.49 (blacks). In addition, at adverse levels of certain risk factors, blacks had more extensive CAD than did whites: mean occlusion scores were 148 (whites) and 238 (blacks) at HDL cholesterol levels less than 30 mg/dl. As assessed by multiple linear regression, however, only triglyceride levels were differentially related to CAD between whites (beta = 0) and blacks (beta = 0.47), p less than 0.01 for racial contrast. These results document the importance of risk factors in black men and indicate black/white differences in the relation of triglycerides to CAD.

Adult↗

PubMed1988

Postmenopausal use of estrogen and occlusion of coronary arteries.

The degree of coronary artery occlusion was compared between users and nonusers of postmenopausal estrogen among 933 female patients undergoing angiography between the ages 50 and 75 years in the Milwaukee Cardiovascular Data Registry. Users (n = 154) had less occlusion than nonusers (n = 779), and a significant increase in occlusion scores with age was evident for nonusers (p less than 0.001) but not for users (p = 0.50). The age-adjusted odds ratios for use of postmenopausal estrogen among women with moderate and severe levels of occlusion of the coronary arteries were 0.59 (95% confidence interval, 0.48 to 0.73) and 0.37 (95% confidence interval, 0.29 to 0.46), respectively, which indicated a statistically significant, apparent protective effect of postmenopausal estrogen on coronary occlusion. This effect was independent of the type of menopause or other risk factors but not independent of high-density lipoprotein-cholesterol levels. Higher high-density lipoprotein-cholesterol levels among users may indicate a biologic mechanism by which postmenopausal estrogen use lowers the risk of coronary occlusion.

Aged↗

PubMed1988

Calcium intake and the relationship of dietary sodium and potassium to blood pressure.

Using First National Health and Nutrition Examination Survey (NHANES I) data, we studied the relationships of dietary sodium, potassium, and alcohol to blood pressure in relation to levels of dietary calcium intake. At low Ca intakes (less than 400 mg/d for men and less than 800 mg/d for women) the ratio of Na to K (Na:K) was significantly related to blood pressure (p less than 0.01) after controlling for age, body mass index (BMI), race, and gender. At higher Ca intakes neither Na:K nor any other nutrient (with the exception of alcohol) was related to either systolic or diastolic blood pressures. Na:K was more strongly related to blood pressure than either nutrient alone and low Ca intakes were necessary for the Na:K-blood pressure relationship to be evident. Interaction of these three dietary factors in relation to blood pressure was evident in all race and gender groups. Associations of age, BMI, gender, and alcohol with blood pressure were not affected by Ca levels.

Adolescent↗

PubMed1987

Effect of head-out water immersion on cardiorespiratory response to dynamic exercise.

Head-out water immersion is known to produce several cardiopulmonary adjustments at rest due to a cephalad shift in blood volume. The purpose of this study was to determine the effect of head-out water immersion on the cardiorespiratory response to graded dynamic exercise. Nineteen healthy middle-aged men performed upright cycling exercise at 40, 60 and 80% of maximal oxygen consumption on land and in water (31.0 +/- 1.0 degrees C) to the shoulders. Cardiac output (measured by the carbon dioxide rebreathing technique) was significantly greater in water at 40 and 80% maximal oxygen consumption. Stroke volume was significantly elevated at all stages of exercise. Heart rate did not differ significantly at 40 and 60% maximal oxygen consumption but was significantly lower in water at 80% maximal oxygen consumption. Total ventilation did not differ significantly in water and on land at any stage of exercise. The results suggest that the central redistribution of blood volume with head-out water immersion leads to an increase in stroke volume. Because there is not a proportional decrease in heart rate with the elevated stroke volume, cardiac output is regulated at a higher level during upright exercise in water compared with that on land. In conclusion, there are serious limitations of available, prerecorded rhythm data bases for designing and testing of automatic external defibrillators. Performance can be adequately assessed only by extensive clinical tests, which seem mandatory for this new and important type of defibrillator.

Adult↗

PubMed1986

A rapid and accurate method of estimating body weight.

Pediatric cardiopulmonary resuscitation drug therapy is based upon body weight, a statistic that often requires estimation. Using two current techniques of estimating body weight and the devised weight-estimating method (DWEM), the authors estimated the weights of 258 children. The DWEM, which is based on body habitus and height, was more accurate than other methods (P less than 0.01). Using height, habitus, sex, and age in a multiple regression analysis, habitus and height--two readily available measurements--were the best predictors of body weight. The DWEM, based on these two measurements, is a simple method of estimating children's weights and is more accurate than currently used body-weight estimations.

Adolescent↗

PubMed1986

A blinded clinical comparison of MR imaging and CT in neuroradiology.

The sensitivity and specificity of magnetic resonance (MR) imaging and computed tomography (CT) were compared in blinded readings of images of a consecutive series of patients with subsequently proved diagnoses. Overall, MR imaging was less sensitive than CT because of its lower sensitivity in detecting benign tumors. With a similar experimental protocol, the effects of technical refinements or contrast media on the sensitivity of MR imaging can be determined.

Aged↗

PubMed1985

Alcohol, nutrient intake, and hypertension in US adults.

Data from the first Health and Nutrition Examination Survey were analyzed with multivariate statistical techniques to determine whether there was evidence for a contributory role of alcohol in hypertension and to provide a suitable perspective on the importance of nutrient variables compared with other established risk factors for hypertension. The results of these analyses reaffirm the importance of alcohol and sodium intakes on blood pressures among US adults. Potassium (inversely) and phosphorus (directly) were also identified as important nutrient predictors of higher systolic blood pressure. Calcium intake was significantly related to systolic blood pressure only among nonwhite men and was not a significant predictor of systolic pressure overall. In addition, the results of the study reemphasized the paramount importance of age, race, and obesity in determining hypertension. Current nutrient intakes, by comparison, are relatively less important.

Adolescent↗

PubMed1985

Characterization of elevated plasma alkaline phosphatase activity in genetically obese mice.

Alkaline phosphatase activity in obese mice (C57BL/6J ob/ob) was significantly increased from 18 to 63 weeks of age when compared to that of their lean controls (C57BL/6J +/?). In 5 week old animals, the earliest age examined, the circulating activity of alkaline phosphatase was similar in both obese mice and their lean counterparts. To characterize the circulating alkaline phosphatase activity in the obese mouse and its lean counterpart, the response of the enzyme to fasting, various inhibitors, heat inactivation, and urea denaturation was examined and compared. L-homoarginine and L-p-bromotetramisole inhibited to a large extent the circulating activity of alkaline phosphatase in both obese mice and their lean controls in the fed state, while L-phenylalanine had essentially no effect. Even though the response of alkaline phosphatase in plasma to several inhibitors was similar, the rate of denaturation by urea of enzyme activity in plasma was significantly slower in obese mice than in their lean controls in the fed state. While the rate of inactivation of alkaline phosphatase activity in plasma for the initial two minutes at 56 degrees C was similar in obese mice and their lean counterparts, the subsequent rate of heat inactivation was significantly slower in the plasma from obese mice. Thus, both obese and lean mice in the fed state have a circulating activity of alkaline phosphatase in plasma with a greater contribution from a skeletal isoenzyme and a lesser one of intestinal origin.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗

PubMed1985

Alcohol consumption, nutrient intake and relative body weight among US adults.

Data from the first National Health and Nutrition Examination Survey (HANES I) were analyzed for differences in nutrient intakes based on the amounts of alcohol consumed by US adults, and for relationships between alcohol consumption, calorie intake, and relative body weight. Drinkers had significantly higher intakes of total calories than nondrinkers, but only because of their intakes of alcoholic calories. Among drinkers, the intakes of nonalcoholic calories decreased as alcohol intakes increased, and it was estimated that between 15 and 41% of the alcoholic calories replaced nonalcoholic calories. Despite their higher caloric intakes, drinkers were not more obese than nondrinkers, suggesting that alcoholic calories may be less efficiently utilized than nonalcoholic calories, or may interfere with utilization of nonalcoholic calories. The most salient difference in nutrient intake between drinkers and nondrinkers was the substantially lower carbohydrate intake of drinkers.

Adult↗

PubMed1984

The origin of plasma alkaline phosphatase activity in mice and rats.

Swiss albino mice displayed the highest activity of alkaline phosphatase at 4-6 weeks with a precipitous decline by 18 weeks of age to a value seen in the mature animal. Circulating activity of alkaline phosphatase was significantly higher in the rat than the mouse in the fed state. With fasting, enzyme activity declined in the rat yet increased in the mouse. The net result was significantly higher plasma alkaline phosphatase activity in the mouse than the rat after the 48 hr fast. L-Phenylalanine inhibition of plasma alkaline phosphatase was greater in plasma from the rat than the mouse in the fed state. Yet in the fed condition, L-homoarginine and L-p-bromotetramisole inhibited alkaline phosphatase activity in plasma from mice to a greater extent than in rats. Heat inactivation as well as urea denaturation of alkaline phosphatase was significantly faster with plasma of the mouse than the rat in the fed state. Thus, it appears that the alkaline phosphatase isoenzyme of skeletal origin contributes a greater proportion of the circulating activity in the fed Swiss albino mouse than occurs in the Sprague-Dawley rat in which the intestinal isoenzyme plays a greater role in the fed condition.

Aging↗

PubMed1984

Enzyme activities of hepatic glucose utilization in the fed and fasting genetically obese mouse at 4-5 months of age.

Activities of key enzymes in hepatic glucose utilization were compared between obese (C57BL/6J ob/ob) mice, their lean controls and outbred Swiss albino mice in the fed condition and during fasting. As liver hyperplasia and hepatocyte hypertrophy were present in the ob/ob mice at 4-5 months of age and changes in hepatic cellularity did occur with fasting, enzyme activity was expressed on the basis of protein, DNA, and wet weight. In the fed state, activities of glucokinase + hexokinase (glucose phosphorylating capability), phosphofructokinase and pyruvate kinase were significantly greater in livers of ob/ob mice when compared to those of the lean control. Glucokinase + hexokinase activities in livers of ob/ob mice remained significantly higher throughout the 48 h fast yet the activities of hepatic phosphofructokinase and pyruvate kinase, when expressed per g wet wt or mg protein, decreased so that a statistical difference from the fasted lean control was no longer detected. When expressed per 100 g body weight, hepatic glucokinase + hexokinase as well as phosphofructokinase and pyruvate kinase activities in obese mice were higher both in the fed and fasted states when compared to lean controls in the comparable nutritional condition. This increased capacity of key enzyme activities in hepatic glucose utilization can be attributed to liver hyperplasia found in ob/ob mice in both the fed and fasted condition. While higher hepatic glucose phosphorylating capability was maintained during fasting, the elevated specific activities of hepatic phosphofructokinase and pyruvate kinase in the obese mouse in the fed state decreased with starvation to values found in the lean control.

Animals↗

PubMed1984

A metabolic profile of fed and fasting genetically obese mice at 4-5 months of age.

Indices of both carbohydrate and lipid metabolism were examined in obese (C57BL/6J ob/ob) mice and lean controls at 4-5 months of age in both the fed and fasted condition. Swiss albino mice (1.5-2 months in age), weight-matched to the inbred lean mice, were also investigated but differences in the metabolic parameters between these groups of mice were confounded by the dissimilarity in age. The concentrations of lactate and alanine in plasma were significantly higher in ob/ob mice than the lean controls in the fed state but this difference disappeared with fasting. Plasma levels of FFA and glycerol were similar in all three groups of mice in both the fed and fasted states. The significantly lower concentrations of plasma ketone bodies in ob/ob mice than the lean controls after a 24 h fast would suggest that the transition from the fed to fasted condition in the hepatic metabolism of the obese mouse does indeed occur more slowly. Yet after a 48 h fast, ob/ob mice had significantly higher levels of hepatic glycogen than comparably fasted lean control. Likewise, plasma glucose values decreased in ob/ob mice during food deprivation but remained significantly higher than those of the lean controls after 48 h fast. Excessive accumulation of triacylglycerols in liver and heart found in ob/ob mice in the fed condition was maintained during a fast of 48 h even though their level in plasma was significantly lower than in the comparably fasted lean control. We propose that an increase in the concentration of triacylglycerols in liver, heart and skeletal muscle may be an intracellular index of decreased insulin effectiveness in the genetically obese mouse.

Alanine↗

PubMed1983

Comparison of carbohydrate and lipid metabolism in mice and rats during fasting.

1. Swiss albino mice and Sprague-Dawley derived rats, 6-8 weeks in age were compared in the fed condition and after a fast of 24 and 48 hr. 2. Plasma glucose was significantly higher in mice than rats in the fed state but this difference disappeared after the 48 hr fast. 3. In the fed condition, plasma FFA and glycerol levels were significantly higher in mice than rats yet did not change during fasting. With starvation, there was a progressive increase in plasma FFA in the rat but no change in plasma glycerol. 4. The content of triacylglycerols in the plasma and liver was comparable in mice and rats in the fed state. Plasma triacylglycerols declined to a similar extent in both species during a fast of 48 hr. In mice, hepatic triacylglycerols increased markedly during fasting but declined in rats. 5. Heart triacylglycerols were higher in mice than rats in the fed state and increased still further during a fast of 48 hr during which time little change was observed in the rat. Myocardial glycogen was comparable in mice and rats in the fed state. With fasting, cardiac glycogen content decreased in the mouse but remained unchanged in the rat. 6. Distinct differences in certain of the parameters of carbohydrate and lipid metabolism were found with mice and rats in the fed and fasted condition.

Animals↗

PubMedDate not supplied

Body fat distribution, plasma lipids, and lipoproteins.

The relation of body fat distribution as measured by the ratio of waist to hip circumferences (WHR) to plasma levels of lipids and lipoproteins was studied in 713 men and 520 women who were employed by two Milwaukee companies. Quetelet index (kg/m2), waist girth, hip girth, and WHR were each positively related to levels of total cholesterol, triglycerides, apolipoprotein B, and the ratio of total to high density lipoprotein (HDL) cholesterol. In addition, the anthropometric measures were inversely associated with levels of HDL cholesterol. (Controlling for age, alcohol intake, exercise level, current smoking status, and oral contraceptive use only slightly reduced the strength of the correlations.) In addition, WHR and Quetelet Index were independently related to lipid and lipoprotein levels, and the magnitudes of the associations were roughly equivalent. For example, the mean (covariate-adjusted) triglyceride level among men in the upper tertile of the Quetelet Index was 37 mg/dl higher than for men in the lower tertile of the Quetelet Index; the corresponding difference according to WHR tertiles (upper to lower) was 39 mg/dl (p less than 0.01 for both effects). These findings indicate that in healthy men and women a less favorable lipid and lipoprotein profile is associated with elevated levels of both Quetelet Index and WHR.

Adipose Tissue↗