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Biomedical subjects

L L Humphrey

Publications and source records attributed to L L Humphrey.

At least 19 recordsLinked to original sources
PubMed1998

Screening digital rectal examination and prostate cancer mortality: a case-control study.

BACKGROUND: Prostate cancer is the second most common cause of death from cancer in men in the United States. Digital rectal examination is the oldest and most commonly used screening test for prostate cancer, but as yet there are no studies which demonstrate its effectiveness. METHODS: A case-control study was conducted among members of a large health maintenance organisation to estimate the effect of screening digital rectal examination on mortality from prostate cancer. 150 men, aged 40-84 when cancer was diagnosed, who developed fatal prostate cancer, and 299 male controls matched for age who did not die from prostate cancer were studied. A history of screening digital rectal examination during the 10 years before the date on which cancer was-diagnosed was determined from medical records. RESULTS: A similar proportion of men who died from prostate cancer and controls had undergone at least one screening digital rectal examination during the 10 year interval (odds ratio = 0.84, 95% confidence interval 0.48 to 1.46). Similar results were obtained when a shorter interval (such as five years before diagnosis) during which screening histories were evaluated was considered, or in analyses in which men with a history of benign prostatic hypertrophy were excluded. CONCLUSIONS: The data suggest that screening digital rectal examination does not reduce mortality from prostate cancer to any appreciable degree.

Adult↗
PubMed1997

Affect and self-regulation in binge eaters: effects of activating family images.

OBJECTIVE: This study examined the impact of activating internalized family images on affective states and behavioral self-regulation. METHOD: Sixty-four female binge eaters and normal controls were randomly assigned to family- or neutral-state inductions. RESULTS: The family induction had a differentially negative impact on binge eaters. When their family images were activated, binge eaters felt more negatively about the experiment, more hostile, experienced greater sensations of hunger, and were more preoccupied with their family images than their counterparts in the other groups. Behaviorally, they also required a relatively greater amount of time to complete a visual-motor task, with a degree of accuracy comparable to that of other subjects. DISCUSSION: The present findings suggest that for women with eating disorders, the activation of internalized images of their family relationships may produce distress and perhaps problems in behavioral self-regulation as well.

Adult↗
PubMed1996

Structural analysis of families with a polydrug-dependent, bulimic, or normal adolescent daughter.

This study compared perceived relationships and interaction patterns among 44 families with externalizing (polydrug-dependent), internalizing (bulimic), or normal adolescent daughters. Data from L.S. Benjamin's (1974) structural analysis of social behavior rating scales and observational coding system were subjected to a pattern analysis of effect sizes. Results revealed that families of polydrug-dependent girls were less well attached and less autonomous than were families of daughters with bulimia who were, in turn, less attached and autonomous than controls. Observed interactions also showed that parents of drug-dependent teenagers communicated a mixed message of blaming the daughter while pseudo-affirming her. The findings were interpreted as evidence for specific disturbances in the critical elements of attachment and autonomy in both clinical disorders, with more pronounced and pervasive problems in the families of polydrug-dependent girls.

Adolescent↗
PubMed1994

The contribution of non-insulin-dependent diabetes to lower-extremity amputation in the community.

BACKGROUND: Despite the significant public health burden of lower-extremity amputations in diabetes mellitus, few data are available on the epidemiology of lower-extremity amputations in diabetes mellitus in the community setting. METHODS: A retrospective incidence cohort study based in Rochester, Minn, was conducted. RESULTS: Among the 2015 diabetic individuals free of lower-extremity amputation at the diagnosis of diabetes mellitus, 57 individuals underwent 79 lower-extremity amputations (incidence, 375 per 100,000 person-years; 95% confidence interval, 297 to 467). Among the 1826 patients with non-insulin-dependent diabetes mellitus, 52 underwent 73 lower-extremity amputations, and the subsequent incidence of lower-extremity amputation among these residents was 388 per 100,000 person-years (95% confidence interval, 304 to 487). Of the 137 insulin-dependent diabetic patients, four subsequently underwent five lower-extremity amputations (incidence, 283 per 100,000 person-years; 95% confidence interval, 92 to 659). Twenty-five years after the diagnosis of diabetes mellitus, the cumulative risk of one lower-extremity amputation was 11.2% in insulin-dependent diabetes mellitus and 11.0% in non-insulin-dependent diabetes mellitus. When compared with lower-extremity amputation rates for Rochester residents without diabetes, patients with non-insulin-dependent diabetes mellitus were nearly 400 times more likely to undergo an initial transphalangeal amputation (rate ratio, 378.8) and had almost a 12-fold increased risk of a below-knee amputation (rate ratio, 11.8). In this community, more than 60% of lower-extremity amputations were attributable to non-insulin-dependent diabetes mellitus. CONCLUSIONS: These population-based data document the magnitude of the elevated risk of lower-extremity amputation among diabetic individuals. Efforts should be made to identify more precisely risk factors for amputation in diabetes and to intervene in the processes leading to amputation.

Amputation, Surgical↗
PubMed1994

A multimethod analysis of families with a polydrug-dependent or normal adolescent daughter.

We compared behavioral interactions and perceived relationships in families of drug-dependent and normal adolescent girls. A total of 29 family triads including father, mother, and teenage daughter participated. L. S. Benjamin's (1974) structural analysis of social behavior model and methodology were used to code videotaped interactions and to rate self and other in perceived relationships. Observations of parental behavior toward their daughters did differentiate families of drug abusers from control families, but daughters' behavior did not. Parents communicated a conflictual message of both greater affirmation and condemnation of their daughter's autonomy. Both parents and daughters in the drug-dependent group blamed the daughters, despite their actual behavior, for the family's problems. The findings are interpreted as consistent with social-developmental and psychoanalytic theories of adolescent substance abuse as derailed individuation from the family.

Adolescent↗
PubMed1993

Cognitive, behavioral, and family factors in the differentiation of depressive and anxiety disorders during childhood.

Contribution of cognitive, behavioral, and family environment variables to the differentiation of depressive and anxiety disorders in children was explored. Fifty-nine children from Grades 4-7 (14 diagnosed with a depressive disorder, 16 diagnosed with depressive and anxiety disorders, 11 diagnosed with an anxiety disorder, and 18 nondisturbed controls) completed measures of the depressive cognitive triad, depressive cognitions, social skills, family environment, and maladaptive family messages. Results of a stepwise discriminant function analysis indicated that 2 discriminant functions composed of 7 variables from the cognitive, behavioral, and family environment domains accounted for 91% of the between-groups variance. Results suggest that depressive disorders can be distinguished from anxiety disorders on the basis of ratings of cognition, social skills, and family environment. Implications for existing research and a model of depression during childhood are discussed.

Adolescent↗
PubMed1990

Perceived family environments of depressed and anxious children: child's and maternal figure's perspectives.

This study examined perceived environment among families with a depressed, depressed and anxious, anxious, or normal child from the 4th to 7th grades. Fifty-one such children were classified according to criteria from the K-SADS and a set of self-ratings of depression and anxiety. Results showed that children in all three diagnostic groups, and to a lesser extent their mothers, experienced their families as more distressed on a host of dimensions relative to controls. In addition, significant differences were found between families with a depressed and anxious child and those with an anxious child. Discriminant function analyses revealed that 68.63% of the youngsters could be classified correctly into depressed and anxious groups on the basis of their family ratings alone.

Adolescent↗
PubMed1990

Renal complications in non-insulin-dependent diabetes mellitus.

Renal failure among elderly individuals with diabetes is a substantial clinical and public health problem. These individuals account for the majority of renal failure among people with diabetes mellitus in the United States. Although limited population-based data directly provide evidence regarding the incidence of and risk factors for ESRD, extant data suggest that blacks and Pima Indians have a markedly increased risk of ESRD compared with whites in the United States. Proteinuria and microalbuminuria appear to be extremely common in elderly individuals with NIDDM and are strongly associated with overall survival, cardiovascular morbidity and mortality, and the development of ESRD. Although randomized clinical trials are needed to test intervention strategies to reduce morbidity and mortality associated with renal disease among individuals with NIDDM, extant data suggest that management efforts directed at hypertension control and, possibly, moderate restriction of protein intake may be important therapeutic modalities for prevention of renal disease and its associated sequelae among elderly individuals with diabetes.

Adult↗
PubMed1989

Chronic renal failure in non-insulin-dependent diabetes mellitus. A population-based study in Rochester, Minnesota.

STUDY OBJECTIVE: To identify the incidence of clinically defined chronic renal failure by clinical type of diabetes in a community diabetic incidence cohort, and to evaluate the relation between persistent proteinuria and chronic renal failure in non-insulin-dependent diabetes mellitus. DESIGN: Retrospective incidence cohort study. SETTING: Population-based in Rochester, Minnesota. PATIENTS: Residents of Rochester, Minnesota, with diabetes initially diagnosed between 1945 and 1979 who had follow-up to 1984 for clinically defined chronic renal failure. MEASUREMENTS AND MAIN RESULTS: Among 1832 persons with non-insulin-dependent diabetes who were initially free of chronic renal failure, 25 developed chronic renal failure (incidence, 133 per 100,000 person-years: CI, 86 to 196). The subsequent incidence of chronic renal failure among 136 insulin-dependent diabetic Rochester residents, three of whom developed chronic renal failure, was 170 per 100,000 person-years (CI, 35 to 497). After adjusting for potential confounding factors, we found that the risk for chronic renal failure associated with the presence of persistent proteinuria at the time of the diagnosis of non-insulin-dependent diabetes was increased 12-fold (hazard ratio, 12.1; CI, 4.3 to 34.0). When persistent proteinuria developed after the diagnosis of non-insulin-dependent diabetes mellitus, the cumulative risk for chronic renal failure 10 years after the diagnosis of persistent proteinuria was 11%. CONCLUSIONS: These population-based data suggest that most cases of chronic renal failure in diabetes occur in persons with non-insulin-dependent diabetes. These data also identify the increased risk for chronic renal failure among persons with non-insulin-dependent diabetes mellitus who have persistent proteinuria present at or developing after the diagnosis of non-insulin-dependent diabetes mellitus, such data may be useful for directing interventions to prevent or delay the development of chronic renal failure.

Cohort Studies↗
PubMed1989

Observed family interactions among subtypes of eating disorders using structural analysis of social behavior.

Compared observations of family interactions among anorexic, bulimic-anorexic, bulimic, and normal families. A total of 74 family triads participated, including father, mother, and teenage daughter. Each family was videotaped during a 10-min discussion of the daughter's separation from the family. These tapes were coded using Benjamin's structural analysis of social behavior (SASB) model and observational schema. The results showed that the SASB methodology differentiated clinical from normal families and that there were unique patterns among subtypes of eating disorders. Specifically, parents of anorexics communicated a double message of nurturant affection combined with neglect of their daughter's needs to express themselves and their feelings. Anorexic daughters, in turn, were ambivalent about disclosing their feelings versus submitting to their parents. In contrast, bulimics and their parents were hostilely enmeshed and, for them, this appeared to undermine the daughter's separation and self-assertion. These findings are consistent with current theory and research on anorexia and bulimia.

Adolescent↗
PubMed1989

Early detection of breast cancer in women.

Breast self-exam, clinical breast exam and mammography are the primary screening modalities for the early detection of breast cancer. In this article, we review the epidemiology of breast cancer and methodologic considerations in screening for breast cancer. For each screening modality, we assess the evidence for its effectiveness in reducing breast cancer mortality. For each modality we also discuss the limitations, cost/benefit considerations, utilization, and published recommendations for use. This article is intended to facilitate primary care providers in decision-making regarding the early detection of breast cancer.

Breast↗
PubMed1988

Epidemiology of persistent proteinuria in type II diabetes mellitus. Population-based study in Rochester, Minnesota.

Clinical risk factors for nephropathy were assessed in a population-based study of Rochester, Minnesota, residents with diabetes mellitus initially diagnosed between 1945 and 1969 (incidence cohort). The 1031 Rochester residents with non-insulin-dependent diabetes mellitus (NIDDM) were followed through their complete medical records in the community to 1 January 1982. The prevalence of persistent proteinuria was 8.2% at the diagnosis of NIDDM. Among those initially free of persistent proteinuria, the subsequent incidence was 15.3/1000 person-yr. Twenty years after the diagnosis of diabetes, the cumulative incidence of persistent proteinuria was 24.6%. A proportional hazards model identified the following risk factors for persistent proteinuria in NIDDM: elevated initial fasting blood glucose (P less than .01); older age at onset of diabetes (P less than .01); male gender (P = .05); and presence of macrovascular disease (P = .05), diabetic retinopathy (P = .05), or glycosuria (P = .07) at the diagnosis of diabetes. Separate analyses controlling for attained age indicated no association between duration of NIDDM and the incidence of persistent proteinuria. Stratified analysis of the two most significant risk factors (fasting blood glucose and age) indicated that hyperglycemia was a stronger risk factor for proteinuria in younger diabetic subjects, perhaps because of a competing risk of death in the elderly diabetic patient. In contrast to a recently described decreasing secular trend of proteinuria in Danish insulin-dependent diabetes mellitus patients, there was no decrease over the past 40 yr in proteinuria risk in this NIDDM incidence cohort.

Adult↗
PubMed1988

Screening mammography.

Breast cancer is the most commonly occurring cancer in women and, until recently surpassed by lung cancer, was the leading cause of cancer-related death in women. It is the leading cause of death in women aged 39 to 44 years. The American Cancer Society has estimated that there will be 135,000 new cases of breast cancer and 42,300 breast cancer-related deaths in 1988. It is now predicted that breast cancer will develop in one out of every ten women in the United States. Given the clinical and public health significance of breast cancer, annual screening with mammography and clinical breast examination is recommended for women aged 50 and older to reduce breast cancer mortality.

Adult↗