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Biomedical subjects

L Weissfeld

Publications and source records attributed to L Weissfeld.

11 recordsLinked to original sources
PubMed1998

Small low-density lipoproteins and vascular cell adhesion molecule-1 are increased in association with hyperlipidemia in preeclampsia.

The pregnancy disorder preeclampsia is characterized by endothelial cell dysfunction that may be promoted by abnormal increases in circulating lipids, particularly triglycerides and free fatty acids. Serum triglyceride concentration is a major regulatory determinant of low-density lipoprotein (LDL) size and density distribution. Smaller, denser LDL particles have several intrinsic properties capable of inducing endothelial dysfunction. The present nested, case-control study of gestationally matched preeclamptic and normal pregnant women tested the hypothesis that hypertriglyceridemia in preeclampsia is accompanied by decreases in LDL peak particle diameter (predominant LDL size). Plasma LDL peak particle diameter was determined by nondenaturing 2% to 16% polyacrylamide gel electrophoresis. Correlations of LDL diameter with the concentration of serum triglycerides, free fatty acids, total cholesterol, LDL-cholesterol, and apolipoprotein B (apo B) were determined. In the same individuals, we measured serum concentrations of a marker of vascular dysfunction previously reported to be increased in preeclampsia, soluble vascular cell adhesion molecule-1 (VCAM-1), and examined the association of VCAM-1 with LDL diameter and serum lipids. LDL peak particle diameter was decreased in preeclampsia relative to normal pregnancy (P < .01). The LDL-cholesterol:apo B ratio, which frequently decreases with decreasing LDL diameter, was also decreased (P < .04). Triglyceride concentrations were increased in preeclampsia (P < .0002), and there was a significant inverse relationship between LDL peak particle diameter and triglycerides (r = -.55, P < .02). Serum soluble VCAM-1 concentrations were markedly increased in preeclampsia (P < .0003). Apo B (P < .004), free fatty acids (P < .01), total cholesterol (P < .01), and LDL-cholesterol (P < .02) were also increased. VCAM-1 correlated with apo B (r = .50, P < .03) and LDL-cholesterol (r = .50, P < .03), but showed no relationship with the LDL diameter, LDL-cholesterol:apo B ratio, or other lipids. We conclude that the predominance of smaller, denser LDL, a potential contributor to endothelial cell dysfunction, is a feature of preeclampsia. However, the serum VCAM-1 level, one indicator of endothelial involvement, may be influenced more by quantitative lipoprotein changes (serum apo B or LDL-cholesterol) than by LDL particle size.

Case-Control Studies↗
PubMed1995

Discharge planning from home health care and patient status post-discharge.

An exploratory study of 57 elderly patients discharged from home health agencies sought to identify how they and their caregivers were prepared for discharge and how they were managing. Data were collected from the home care records and post-discharge interviews with patients and caregivers. Results indicate little evidence of formal discharge planning. However, home care records appear to underreport what home care staff do. On follow-up, over half of the patients had improvement in their health, two-thirds were independent in activities of daily living, and few patients had need of formal services.

Aged↗
PubMed1991

Progression of osteoarthritis of the hand and metacarpal bone loss. A twenty-year followup of incident cases.

We examined the prospective relationship between metacarpal bone mass and osteoarthritis (OA) of the hand, using incidence data from the historical cohort in the Tecumseh Community Health Study (Tecumseh, MI). Women were examined for radiographic evidence of OA and for bone mass twice, 20-23 years apart (1962-1965 and 1985; 683 subjects with an age range of 55-74 in 1985). Two measures of OA were evaluated: the highest score assigned to any of the 32 wrist/hand joints, and the sum of scores for all wrist/hand joints. After adjustment for age, women who were classified as having OA (by either measure of OA) in 1985 were more likely to have more cortical area at baseline, which indicates greater bone mass. Women who developed OA in the 23-year period were more likely to experience a significantly greater widening of the medullary cavity over time, an indicator of increased bone resorption. Women with increasing levels of OA involvement also had an increased likelihood of greater cortical area loss. We conclude that women who later developed OA were more likely to have higher baseline bone mass than women who did not develop OA, but these women also had a greater likelihood of bone loss over time.

Adult↗
PubMed1990

Familial transmission of alcohol use, III. Impact of imitation/non-imitation of parent alcohol use (1960) on the sensible/problem drinking of their offspring (1977).

Imitation/non-imitation by adult offspring of alcohol-related parent behavior was examined in the context of the 'fall-off effect' and of sensible/problem alcohol use, two processes which tend to constrain drinking. Evidence indicates there is more imitation by adult offspring of abstemious parents (both abstainer and low volume) than of high volume parents. Adult offspring drink significantly less, on the average, than their high volume parents, a phenomenon here termed 'fall-off effect' for both men and women with respect to either their fathers or mothers. This fall-off among social drinkers appears when the mother approaches or the father consumes at or more than a typical daily drinking level (greater than or equal to 1 drink per day). More sensible drinking occurs among adult offspring when (1) the parent has no drinking problem-signs than when the parent has drinking problems (this pattern appears at all levels of offspring consumption), and (2) when parents drink at high volume and have no problems for those offspring who do not imitate parent volume. Drinking 'sensibly' appears to be associated directly with the level of parent alcohol use and offsprings' own drinking levels (considered as imitation or non-imitation of parents), and indirectly with offspring recall of problematic intake by parents. Drinking sensibly is a medical, education and public health issue.

Adult↗
PubMed1987

The prevalence and correlates of Rose Questionnaire angina among women and men in the Lipid Research Clinics Program Prevalence Study population.

The prevalence and correlates of Rose Questionnaire angina were investigated in a sample of 4,661 white woman and men aged 30 years and above who participated in the Lipid Research Clinics Program Prevalence Study 1972-1976. Among men, the prevalence of Rose angina increased with age from about 1% to 12%, while the prevalence among women ranged from about 3% to 6%. Young women compared with men also had a relatively high prevalence of dyspnea, which was strongly correlated with Rose angina in both sexes. For women and men younger than 50 years, the dyspnea-Rose angina odds ratio was about 6 (p less than 0.001), while older women and men had somewhat lower sand higher odds ratios, respectively. Major and minor resting electrocardiographic abnormalities and self-reported history of a heart attack were not significantly associated with Rose angina among young participants of either sex, but they did show positive associations among older participants with the exception of minor electrocardiographic abnormalities in men. A logistic regression analysis revealed a strong inverse association between high density lipoprotein cholesterol and Rose angina in both sexes. Because mortality studies consistently show an excess of coronary heart disease death among young men compared with women, the female excess of Rose angina at young ages suggests that the grouping of angina and myocardial infarction into a single endpoint in cardiovascular disease studies may be more appropriate for young men than for young women.

Adult↗
PubMed1986

Predictive value of the exercise tolerance test for mortality in North American men: the Lipid Research Clinics Mortality Follow-up Study.

More than 3600 white men, from 30 to 79 years old and without a history of myocardial infarction, underwent submaximal treadmill exercise tolerance tests as part of their baseline evaluation for the Lipid Research Clinics Mortality Follow-up Study. The exercise test was conducted according to a common protocol and coded centrally; depression of the ST segment by at least 1 mm (visual coding) and/or 10 microV-sec (ST integral, computer coding) signified a positive test. Concurrent measurements of age, blood pressure, history of cigarette smoking, and plasma levels of lipids, lipoproteins, and glucose, as well as other coronary risk factors, were obtained. Cumulative mortality from cardiovascular disease was 11.9% (22/185) over 8.1 years mean follow-up among men with a positive exercise test vs 1.2% (36/2993) over 8.6 years mean follow-up among men with a negative test. Three-quarters (43) of these deaths were due to coronary heart disease. The relative risk for cardiovascular mortality associated with a positive exercise test was 9.3 before and 4.6 after age adjustment. Cardiovascular mortality rates were especially elevated (relative risk 15.6 before and 5.1 after age adjustment) among the 82 men whose exercise tests were adjusted "strongly" positive based on degree and timing of the ischemic electrocardiographic response. A positive exercise test was also moderately associated with noncardiovascular mortality; the relative risk for all-cause mortality was 7.2 before and 3.4 after age adjustment. The relative risk for cardiovascular mortality associated with a positive exercise test was not appreciably altered by covariance adjustment for known coronary risk factors other than age. A positive exercise test was a stronger predictor of cardiovascular death than were high plasma levels of low-density lipoprotein cholesterol, low plasma levels of high-density lipoprotein cholesterol, smoking, hyperglycemia, or hypertension. Its impact on risk of cardiovascular death was equivalent to that of a 17.4 year increment in age.

Adult↗
PubMed1986

Inference based on type II censored samples.

A method for drawing inferences about the mean of a normal population from small censored samples is discussed. The modified standardized statistic presented takes into account the correlation between the estimates of the mean and standard deviation and thus gives asymmetrical confidence intervals in contrast to the common standardized variate. A bias correction is suggested which improves the performance of the proposed statistic for small samples.

Biometry↗
PubMed1986

The association of dyslipoproteinemia with symptoms and signs of peripheral arterial disease. The Lipid Research Clinics Program Prevalence Study.

Intermittent claudication, leg pain during a graded exercise test (GXT), and resting systolic pressures in the upper and lower extremities were recorded as indicators of peripheral arterial disease at visit 2 of the Lipid Research Clinics (LRC) Prevalence Study. Systolic pressures of the upper and lower extremities were measured in a subsample of participants. We compared lipid levels of persons with and without claudication and with or without GXT-induced leg pain. We also compared lipid levels between groups with high and low arm:ankle systolic blood pressure ratios. Twenty-one (1.0%) men, 10 (1.0%) female nonusers and six (1.0%) female users of gonadal hormones had intermittent claudication determined by standardized questionnaire. Men with claudication had lower high-density lipoprotein (HDL)-cholesterol (35.6 vs 46.4 mg/dl), and their mean triglyceride level and cigarette consumption were higher and regular exercise less frequent. Men with type IIb dyslipoproteinemia were more likely to report claudication. One hundred sixty-nine (4.0%) men, 101 (3.8%) female nonusers, and 47 (4.1%) female users of hormones stopped the GXT because of leg pain. Mean HDL-cholesterol levels were lower for those with GXT-induced leg pain in all three sex-hormone usage groups (42.0 vs 46.9, p less than .001; 53.9 vs 59.4, p less than .001; 65.3 vs 67.2, p = NS) and mean low-density lipoprotein cholesterol levels were higher in those with leg pain on GXT in two of three groups (146.4 vs 146.2, p = NS; 155.7 vs 144.6, p less than .01; 144.4 vs 133.5, p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

The association of dyslipoproteinemia with corneal arcus and xanthelasma. The Lipid Research Clinics Program Prevalence Study.

The prevalence rates of xanthelasma and corneal arcus were computed for normolipidemic and dyslipoproteinemic participants in the Lipid Research Clinics population surveys. The prevalence of both xanthelasma and corneal arcus increased with age, was highest in persons with type II phenotype, and usually low in those with type IV phenotype. The relative effects of age and use of gonadal hormones were different in the two lesions. Both xanthelasma and corneal arcus were associated with increased levels of plasma cholesterol and low-density lipoprotein cholesterol (LDL-C), especially in young males. In general, persons with either lesion had increased odds of having type IIa dyslipoproteinemia but decreased odds of having type IV. Xanthelasma and corneal arcus were highly associated with each other, especially in young people. There was no consistent univariate association of xanthelasma and corneal arcus with smoking, alcohol consumption, blood pressure, obesity, sedentary lifestyle, family history of ischemic heart disease, or glucose and uric acid plasma concentrations. Adjusted odds ratios for ischemic heart disease in participants with xanthelasma and corneal arcus were generally increased, except in older female nonusers of gonadal hormones, in whom they were significantly decreased. Neither xanthelasma nor corneal arcus showed a consistent association with manifestations of peripheral arterial disease. Thus the clinical findings of xanthelasma or corneal arcus, especially in young people, seem to identify persons with plasma lipoprotein abnormalities.

Adult↗
PubMed1985

Coronary risk factors and their pathway of action through coronary raised lesions, coronary stenoses and coronary death. Multivariate statistical analysis of an autopsy series: the Oslo Study.

From 1972 to 1973, 16,202 Oslo men, aged 40 to 49 years, were examined for cardiovascular disease and coronary heart disease (CHD) risk factors. This report describes the results of autopsy examinations from 204 of 471 men who died in this cohort with regard to associations between selected risk factors and (1) raised coronary atherosclerotic lesions (RL), (2) coronary artery stenosis, and (3) CHD death. Total serum cholesterol and blood pressure levels were positively associated with all 3 measures of coronary atherosclerosis and its complications, both in univariate and multivariate analyses, whereas high-density lipoprotein (HDL) cholesterol was highly and inversely related. Triglyceride levels, cigarette smoking, social class and physical activity at work and at leisure were not significantly associated with either of the 3 measures. When RL was added to the model with stenosis as the dependent variable, the risk factors no longer appeared as independent; this is consistent with the hypothesis that these factors, when significant, work through the development of RL to produce stenosis. HDL cholesterol was the only risk factor independently and significantly associated with CHD death when RL or stenosis or both were put into the model for CHD. This points to the possibility of HDL cholesterol also working through mechanisms other than the prevention of RL and stenosis toward CHD death.

Adult↗