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Biomedical subjects

L Suarez

Publications and source records attributed to L Suarez.

At least 73 records · Page 4Linked to original sources

The sex differential in mortality from all causes and ischemic heart disease.

The sex differential in mortality from all causes and ischemic heart disease is examined in an upper-middle class Caucasian community of 3516 adults in southern California, who were followed for a minimum of seven years. The influence of several demographic, behavioral, and biologic risk factors is simultaneously controlled for by means of a multiple logistic analysis. Risk factors include age, marital status, education, cigarette smoking, cholesterol, systolic blood pressure, fasting plasma glucose, and obesity. Both the prevalence and relative mortality risk associated with several risk factors differ by sex. Adjustment decreases the sex differential for mortality from 1.7 to 1.3 for all causes and from 4.8 to 2.4 for ischemic heart disease. When analysis is limited to healthy men and women, the adjusted sex differential in mortality is 1.2 for all causes and 2.0 for ischemic heart disease. Findings of this study are compared with two other population-based studies.

Adult↗

Spouse concordance for systolic and diastolic blood pressure.

Eighty-two per cent of all adult residents of Rancho Bernardo, California, participated in a study of the prevalence of heart disease risk factors in 1972-1974. Spouse correlations for systolic and diastolic blood pressure were examined in 1702 spouse pairs including 403 spouse pairs married 40 or more years. Both systolic and diastolic blood pressure showed significant spouse correlation after adjustment for spouse similarities in age and relative weight (r = 0.102 for systolic, r = 0.114 for diastolic, p less than or equal to 0.05). An examination of blood pressure correlations by duration of marriage and age of wife showed correlations to be influenced by age of wife rather than duration of marriage. Spouse correlations were lowest when the wife was aged 40-49 years and highest when the wife was 50-59 years of age. The differential concordance by wife's age is compatible with different degrees of shared behaviors for couples at different ages.

Adult↗

Isolated systolic hypertension and mortality after age 60 years. A prospective population-based study.

A total of 165 out of 2636 adults aged 60 years or older (6.3 per cent) in Rancho Bernardo, California, had isolated systolic hypertension with a systolic blood pressure greater than or equal to 160 mmHg and a diastolic blood pressure less than 90 mmHg when studied in 1972-1974. A 6.4-year follow-up of this cohort showed isolated systolic hypertension to be as important a risk factor for all-cause mortality as other types of hypertension in both men and women (adjusted relative risk = 1.5, p greater than 0.10). After adjustment for age and other covariates, male but not female subjects with isolated systolic hypertension experienced an excess risk of death from stroke (relative risk = 4.0, p less than 0.10), a relative risk exceeding that seen in men with treated hypertension. Isolated systolic hypertension was unassociated with an excess risk of fatal ischemic heart disease in subjects of either sex in this population. The excess risk of death and stroke is consistent with results published elsewhere, and supports the concept that isolated systolic hypertension is not a benign condition of the elderly. The efficacy and safety of therapeutic intervention in older adults with isolated systolic hypertension remain to be determined.

Aged↗

Seasonal variation in fasting plasma glucose levels in man.

A Southern California community study of 4,541 men and women (aged 20-79 years) showed significant seasonal variation in fasting plasma glucose. There was a mean 0.6 mmol/l difference between highest levels in winter and lowest levels in spring. This difference was consistent over a two-year period, similar at all ages and seen in both men and women. Fasting plasma glucose levels correlated directly with percentage possible sunshine (p = 0.03) and inversely with temperature (p = 0.04). Adjustment for the level of measured obesity did not alter the observed association, but a history of recent weight gain corresponded to the season of maximum fasting plasma glucose level.

Adult↗

Spouse concordance of plasma cholesterol and triglyceride.

Spouse concordance for plasma cholesterol and triglyceride was studied in 1971 spouse pairs including 545 spouse pairs married 40 or more years. Both lipids showed modest but statistically significant age corrected Kendall Tau-B correlations; 0.046 (P = 0.005) for cholesterol and 0.070 (P = 0.0001) for triglycerides. Concordance was not explained by season of sampling or by selective mortality. Relative weight was positively correlated in spouse pairs and appeared to explain much of the observed correlations in cholesterol and triglycerides. Spouse pairs also showed positive correlations for cigarette smoking and egg and milk consumption, though these behavioral variables explained little of the concordance for cholesterol and triglycerides. Lipid concordance was highest in marriages of the shortest (1-9 yr) and longest (40 + yr) durations, as was relative weight concordance, suggesting an interaction between duration of marriage and environmental and/or selective factors affecting plasma lipids.

Animals↗

A community study of alcohol and other factors associated with the distribution of high density lipoprotein cholesterol in older vs. younger men.

High density lipoprotein cholesterol (HDL-C) is independently and inversely correlated with the risk of coronary artery disease. In order to determine whether factors that correlated with HDL-C are similar in younger and older men, 311 men from a community sample were dichotomized into younger (30-59) and older (60-89) age groups. Older men had significantly higher HDL-C levels and were leaner and less likely to smoke cigarettes, but did not differ significantly from younger men with regard to exercise or reported alcohol consumption. Nevertheless, in univariate and multivariate analysis, alcohol was the strongest behavioral correlate of HDL-C in both younger and older men. In both younger and older men aspartate aminotransferase levels within the normal range were strongly associated with HDL-C and with alcohol intake, suggesting that the higher HDL-C levels reported in social drinkers reflect an alcohol-induced liver aberration in lipoprotein metabolism.

Adult↗

Spouse concordance for fasting plasma glucose in non-diabetics.

Spouse concordance for fasting plasma glucose was determined in 1710 currently married spouse pairs from a retired community in Southern California who had married durations of from 1 year to more than 40 years. A highly significant concordance was found in marriages of all durations, with the highest concordance in marriages of short duration. Concordance for fasting plasma glucose was not explained by concordance for education, obesity, cigarette smoking, ingestion of whole milk or eggs, the use of antihypertensive medications or a family history of heart disease. Nor was the observed spouse concordance due to selective mortality of discordant spouse pairs. Although there was significant seasonal variation in fasting plasma glucose levels, spouse concordance was not entirely a function of seasonality of sampling. The data suggest that concordance for other environmental attributes--possibly specific nutrients--is responsible for fasting plasma glucose concordance.

Adult↗

Adjustment for obesity in studies of cardiovascular disease.

To evaluate the validity and implications of using various obesity indices in adjusting or controlling for obesity, correlations were analyzed between six cardiovascular disease risk factors, age, cholesterol, log triglyceride, systolic blood pressure, diastolic blood pressure, and fasting plasma glucose, and weight (W), height (H), and five commonly used obesity indices, W/H, W/H2, 3 square root W/H, -H/3 square root W, and relative weight in a defined population of 4956 men and women. Subjects were residents of Rancho Bernardo, California and were surveyed in 1972-1974. Correlations of weight, height, and the obesity indices were also evaluated with each other. W/H, 3 square root W/H, and -H/3 square root W were highly correlated with weight (correlations = 0.96-0.997), but also correlated with height (correlations = 0.10-0.48). These very high correlations with weight and moderate correlations with height resulted in risk factor correlations with these three indices reflecting weight-risk factor correlations rather than obesity-risk factor correlations. W/H2 and relative weight were not quite so highly correlated with weight (correlations = 0.83-0.89), very highly correlated with each other (correlations = 0.999), and relatively uncorrelated with height (correlations = 0.17-0.01). W/H2 and relative weight risk factor correlations reflected true obesity-risk factor correlations and were significantly greater than risk factor correlations with weight, W/H, 3 square root W/H, and -H/3 square root W. These data strongly support the use of either W/H2 or relative weight for obesity adjustment in cardiovascular disease studies. Use of W/H, 3 square root W/H, or -H/3 square root W may result in underadjustment for obesity.

Adult↗

Association arrays for the study of familial height, weight, lipid, and lipoprotein similarity in three West Coast populations.

A more refined understanding of familial similarity may be achieved through a collection of measures of dependence that is sensitive to a variety of nonlinear trends ans stochastic relationships between trait values. Parent-offspring, spouse, and sibling similarities are examined by association arrays that assess dependence between variables for appropriate classes of functions (e.g., the class of all increasing functions). The methodology is applied to height, weight, lipid, and lipoprotein variables collected in nuclear families at the Seattle, Stanford, and La Jolla Lipid Research Clinics. Among the results obtained using association arrays, there is the suggestion that spouse similarity for standardized weight is strongest for functions emphasizing the higher values of the wives' weight independent of the husbands' weight, and that sibling similarity for high density lipoprotein cholesterol concentrations appears strongest for functions emphasizing the higher values of the siblings. The results deduced from the method of association arrays are compared and contrasted with those obtained from standard correlations.

Adolescent↗

Surgical management of spontaneous hepatic duct perforations.

Spontaneous rupture of the hepatic ducts is an exceedingly rare and unusually unrecognized cause of peritonitis in adults. In the last four years we have operated on three patients with bile peritonitis from hepatic duct perforation caused by calculus erosion. All were elderly, had a prolonged period of symptoms prior to presentation, and were gravely ill at the time of operation. Each perforation was managed differently: one by fine suture closure, one by insertion of a T-tube in the perforation, and the third by T-tube drainage of the common duct when the perforation was inaccessible to repair. Two of the three patients survived and remain healthy without evidence of bile duct stricture three and three and a half years later, respectively.

Aged↗

A multicomponent, multipoint infrared ambient air monitor.

With the tremendous advances in electronics today, it is now possible to take existing analytical instruments and give then a "brain" so that many analytical procedures which were impossible or costly a few years ago can now be done with relative ease, at a fraction of the costs. This paper deals with a microcomputer-controlled air monitor which allows us to identify many different components at a multitude of different locations. System operation is explained as well as data accuracy as they relate to application in a plastics research pilot plant.

Air↗

Mortality follow-up of workers exposed to 1,4-dioxane.

As a result of recent interest in the carcinogenic effect of dioxane, a mortality study was conducted on employees exposed to this compound at a major chemical company plant. Standard follow-up techniques were used to ascertain the vital status of a total of 165 employees ever exposed to dioxane since 1954. Observed deaths from overall cancer were not significantly different from the expected number of deaths. The observations were based on small numbers of deaths of employees who were apparently exposed at low levels and for relatively short exposures.

Adult↗

Clinical characterization and survival of adult patients awaiting liver transplantation in Chile.

Liver transplantation has become widely used for patients with decompensated disease. Because of the shortage of donors, each year more patients die on the waiting list. Our aim was to characterize and evaluate the final outcomes of all listed candidates for liver transplantation during a 34-month period. We retrospectively evaluated all adults listed between January 2000 and November 2002. Sixty-three patients (37 women, mean age 45.8 years) were listed: 48 due to chronic liver disease and 15 for a highly urgent transplantation due to acute liver failure. The main etiology of chronic disease was alcoholic (22%) or primary biliary cirrhosis (17%). Of 52 chronic patients, 26 (50%) were transplanted with a mean waiting time of 168 days. Among the others, 8 died (15%) while awaiting transplantation, 3 (5%) were removed from the list, and 15 patients still await transplantation (28%). Among acute liver failure patients, the main etiologies were autoimmune (25%) and medication induced (25%). Of 15 acute patients, 6 (37.5%) have been transplanted at a mean waiting time of 6.8 days with 100% survival posttransplantation. In this cohort, 6 patients (37.5%) died while awaiting liver transplantation, and 4 (25%) survived with medical support. In conclusion, the severity of liver disease and death rate among our waiting list was similar to that observed in developed countries. It seems reasonable to review our current allocation system based on waiting time on the list. We will have to decide whether to transplant sicker patients or those with hepatocarcinoma (as in the United States recently with the MELD system), thereby possibly decreasing the mortality rate on the waiting list at the expense of higher costs and more difficult postoperative care or to just keep our current policy.

Adult↗