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Biomedical subjects

M A Armstrong

Publications and source records attributed to M A Armstrong.

At least 91 records · Page 5Linked to original sources

Alcohol use and later hospitalization experience.

As an indicator of hospitalization costs, the number of hospitalized days among 82,430 white and black adult health maintenance organization (HMO) members was studied. Baseline data were collected at health examinations from 1978 to 1982. Using all hospitalizations from 1978 to 1983 that were not related to pregnancy and that occurred after examination, multiple regression analyses for each race-sex subgroup were controlled for alcohol use (eight categories), cigarette smoking (four categories), age (three categories), and period of observation. Estimates of hospital days associated with alcohol, age, and smoking were calculated for specific diagnostic categories and for all diagnoses by projecting observed days hospitalized of lifelong alcohol abstainers, persons less than 45 years old, and lifelong nonsmokers. Among men of both races, there was almost no increase in total hospital days associated with alcohol use when all levels of drinking were considered. Among women, because of the preponderance of lighter drinkers who had fewer hospitalizations, the overall percentage of total hospital days associated with alcohol was negative. Several trends were identified between alcohol use and hospital days for the diagnostic groups. Most notable were a deficit of hospital days for circulatory system problems and an excess of hospital days for all neoplasms. In summary, in this population of prepaid health-plan members, use of alcoholic beverages was only a minor factor in total hospitalization experience.

Adult↗

Alcohol use and subsequent cerebrovascular disease hospitalizations.

We studied the relations between reported alcohol use and the incidence of hospitalization for several types of cerebrovascular disease. Daily consumption of three or more drinks, but not lighter drinking, was related to higher hospitalization rates for hemorrhagic cerebrovascular disease, especially intracerebral hemorrhage. Age, blood pressure, and black race were other independent predictors of hemorrhagic events; higher blood pressure appeared to be a partial mediator of the relation between alcohol use and hemorrhagic events. Alcohol use was associated with lower hospitalization rates for occlusive cerebrovascular disease; an inverse relation was present in both sexes, whites and blacks, and for extracranial and intracerebral occlusive lesions. Other predictors of hospitalization for occlusive disease included age, blood pressure, smoking, blood glucose and total cholesterol concentrations, and baseline disease. Our data suggest that heavier drinking increases the risk of hemorrhagic cerebrovascular events, but that alcohol use may lessen the risk of occlusive lesions.

Alcohol Drinking↗

Pancreatic cancer, blood glucose and beverage consumption.

We studied the incidence of pancreatic cancer in 122,894 men and women who had previously reported amount and frequency of coffee, tea, and alcohol consumption; reporting was done at a multi-phasic health check-up (MHC) taken while subjects were members of a large prepaid health plan. We also tested the hypothesis that a pre-clinical effect of pancreatic cancer on glucose homeostasis leads to mild hyperglycemia and a generally increased thirst. If true, this could partially explain the increased consumption of beverages (particularly coffee) reported in association with pancreatic cancer in some case-control studies. However, in the 49 pancreatic cancer cases diagnosed during 6 years of follow-up, we found no evidence of increased risk associated with coffee, tea, or alcoholic beverages. We also found no evidence to support the increased-thirst hypothesis when we examined the 19 cases diagnosed within 12 months of having MHC. We did confirm a significantly increased risk among cigarette smokers (relative risk, 2.5; 95% confidence interval, 1.3-4.7) which was progressive with increasing levels of cigarette use. In addition, risk of pancreatic cancer was greater for persons previously under treatment for diabetes mellitus (relative risk, 4.5; 95% confidence interval, 1.2-16.7). Our results add to the growing body of evidence against a causal role of coffee in pancreatic cancer.

Aged↗

Alcohol consumption and the risk of breast cancer in a prepaid health plan.

We examined breast cancer incidence in a cohort of about 69,000 women who were members of a large prepaid health plan in Northern California and who answered detailed questions about alcohol consumption from 1979 through 1984 as part of a voluntary multiphasic health checkup. Among white, black, and Hispanic women with no prior cancer, breast cancer had developed in 303 by the end of 1984. In analysis controlling only for age there was a progressive increase in breast cancer incidence with each higher level of reported alcohol consumption. In multivariate analyses controlled for age, race, body mass, and smoking, the relative risk at 1-2 drinks per day was 1.5 [95% confidence interval (CI) 1.0-2.3], at 3-5 drinks per day it was 1.5 (95% CI 0.8-2.8), and at 6 or more drinks per day it was 3.3 (95% CI 1.2-9.3). Past drinkers tended to have been heavier drinkers than current drinkers and had a relative risk of 2.2 (95% CI 1.2-3.9). Study of wine, beer, and liquor use did not suggest that any particular alcoholic beverage was responsible. Significant associations with heavy alcohol consumption were strongest among white, and among postmenopausal women. This study adds support to the growing evidence that alcohol may be a risk factor for development of breast cancer.

Adult↗

Cataract extraction. Risk factors in a health maintenance organization population under 60 years of age.

Risk factors for cataract extraction in a young (less than 60 years of age) urban health maintenance organization population were evaluated in a case-control study. The subjects (72 case-control pairs) subscribed to the Kaiser Permanente Medical Care Program in the San Francisco Bay area and had cataract extraction between 1976 and 1980. All patients had visual acuity of at least 20/40 OU, documented before development of cataracts. Thirty-six (50%) of the 72 cataract extraction patients had at least one known risk factor for cataract formation, including trauma, intraocular inflammation, diabetes mellitus, syphilis, oral or topical steroid use, or previous eye surgery. Male patients were found to be a mean of 4.3 years younger than female patients, and diabetics were found to be a mean of 3.5 years older than nondiabetics. Variables found to be related to cataract extraction in univariate analysis included diagnosis of diabetes mellitus, a family history of cataracts, pulse rate, white blood cell count, and syphilis.

Adolescent↗

Reduction of monocyte 5'nucleotidase activity by gamma-interferon in multiple sclerosis and autoimmune diseases.

Ecto-5'nucleotidase (5'NT) activity in the plasma membrane of peripheral blood monocytes from patients with multiple sclerosis (MS), rheumatoid arthritis (RA), myasthenia gravis (MG), motor neuron disease (MND), and from normal control subjects of similar age was determined by radioisotopic assay. The activity in unstimulated monocytes cultured for 24 and 48 hours was found to be higher than normal in 56% of patients with active relapsing MS, 29% of patients with RA, and 7% of patients in the MG/MND group. While the enzyme activity was reduced after cultivation of the cells with recombinant interferon-gamma (gamma-IFN) in all of the groups studied, the percentage reduction was significantly greater in monocytes from patients with active relapsing MS who were in relapse at the time of sampling (p = 0.03). HLA-DR expression was monitored using immunofluorescence staining with monoclonal antibody and showed that similar numbers of monocytes in all patient and control groups expressed this antigen. Thus, while high monocyte 5'NT activity was found principally in patients with active relapsing MS and in some patients with RA, the monocytes from patients with MS were, in addition, exquisitely sensitive to stimulation with gamma-IFN.

5'-Nucleotidase↗

Precursors of essential hypertension: body weight, alcohol and salt use, and parental history of hypertension.

Body mass index, alcohol and salt consumption, and parental history of hypertension were examined as possible predictors of the development of essential hypertension in 1,031 persons, ages 30-49 years at entry, with documented normotension followed by documented hypertension after a mean interval of 6 years. In a comparison with 1,031 matched persistently normotensive persons initial body mass index and percentage increase in body mass index were each predictive of hypertension. Consumption of three or more alcoholic drinks a day at baseline was also predictive, more so if this level of intake persisted than if it diminished. Heavy salt intake as crudely estimated at baseline by one question was also associated with the development of hypertension. Parental history of hypertension was also predictive, more so for hypertension in the mother than for hypertension in the father, and the association was apparent only in female subjects. These characteristics at baseline showed independent associations with subsequent hypertension in multivariate analysis. When follow-up data were included in the multivariate analysis, alcohol consumption at the hypertensive examination was much more strongly related than at the baseline examination, suggesting a short-term effect, and heavy salt consumption was no longer predictive, possibly because of a marked loss of subjects due to missing follow-up data. This large study confirms longitudinally the importance of obesity, weight gain during adulthood, alcohol, family history, and, to some extent, salt as predictive and possibly causal factors for essential hypertension.

Adult↗

Alcohol and breast cancer.

We examined breast cancer incidence in a cohort of about 69,000 women who answered detailed questions about alcohol consumption from 1979 to 1984. Among women with no prior cancer, breast cancer had developed in 303 by the end of 1984 for an age-adjusted incidence of 1.3/1,000 person years of follow-up. In analysis controlling only for age there was a progressive increase in breast cancer incidence corresponding to each higher level of reported alcohol consumption. In multivariate analyses controlling for age, race, body mass, and smoking, the relative risk at 1-2 drinks/day was 1.5 (95% confidence interval (CI) 1.0-2.3), at 3-5 drinks/day was 1.5 (95% CI 0.8-2.8), and at 6 or more drinks/day was 3.3 (95% CI 1.2-9.3). Past drinkers tended to have been heavier drinkers than current drinkers and had a relative risk of 2.2 (95% CI 1.2-3.9). Study of wine, beer, and liquor use did not suggest that any particular alcoholic beverage was responsible. Significant associations with heavy alcohol consumption were strongest among white and postmenopausal women. This study adds support to the growing evidence that alcohol may be a risk factor for development of breast cancer.

Alcohol Drinking↗

The relations of alcoholic beverage use to colon and rectal cancer.

The authors prospectively studied the incidence of cancers of the colon and rectum in 106,203 men and women, both white and black, who supplied data at northern California Kaiser Permanente facilities about use of alcoholic beverages in 1978-1984. Analysis controlling for age, sex, race, body mass index, coffee use, total serum cholesterol, and education showed a positive association of alcohol use to both types of cancer, which was stronger for rectal cancer (trend test, p = 0.03) than for colon cancer (trend test, p = 0.11). When persons with a daily intake of three or more drinks were compared with abstainers, relative risk for rectal cancer was 3.17 (95% confidence interval (CI): 1.05-9.57) and relative risk for colon cancer was 1.71 (95% CI: 0.92-3.19). Women with a daily intake of three or more drinks had a relative risk for colon cancer of 2.56 (95% CI: 1.03-6.40) compared with 1.16 (95% CI: 0.46-2.90) for men. Among drinkers, preference for wine, beer, or hard liquor had no significant independent relation to either type of cancer; those who preferred beer were at slightly greater risk of rectal cancer, but those who preferred wine were more likely to develop colon cancer. These data suggest that total alcohol use, but no one specific beverage type, is associated with increased risk of rectal cancer.

Age Factors↗

Management of prolonged pregnancy: induction of labor versus antepartum fetal testing.

Three hundred two low-risk obstetric patients with an unfavorable cervical examination and well-established gestational age of at least 287 days were randomly selected for management by either antepartum fetal testing or prostaglandin gel cervical ripening followed by aggressive induction of labor and delivery. The patients managed by induction of labor had a lower incidence of meconium-stained amniotic fluid, meconium aspiration, low Apgar scores, postmaturity syndrome, fetal distress, and cesarean delivery than did patients managed with antepartum fetal testing. Our data suggest that prostaglandin gel cervical ripening and induction of labor and delivery by 42 weeks' gestation may be the most appropriate management for patients with well-established gestational age and an unfavorable cervical examination.

Dinoprostone↗

Maternal and fetal factors affecting success of antepartum external cephalic version.

We studied 172 patients who were considered for external cephalic version with tocolysis at term. Before a single attempt at version, a variety of maternal and fetal factors considered likely to affect success were coded for each patient. Maternal age, height, and Quetelet index did not affect success. However, successful version was more likely in parous women than in nulliparous women, and less likely with cornual than with other placentations. Amniotic fluid volume, fetal abdominal circumference, type of breech, and the specific nature of the maternal-fetal spatial relation were also important determinants of success. Fetal biparietal diameter, gestational age, and estimated fetal weight were not. All of these factors can be evaluated before attempting version and can be used when counseling candidates for version.

Adolescent↗

Relations of alcoholic beverage use to subsequent coronary artery disease hospitalization.

Unresolved questions about the inverse relation between alcohol consumption and coronary artery disease (CAD) include; Dose past drinking have a role in the apparently higher CAD risk of abstainers? Is the lower CAD risk found only among lighter drinkers? Does type of alcoholic beverage matter? Are abstainers at higher risk of CAD because symptoms or illness cause many to quit drinking? In a prospective study among 85,001 health examinees giving an alcohol history at a health examination from 1978 through 1982, 756 persons were later hospitalized for CAD in the same years. Using lifelong abstainers as the reference group and controlling for age, sex, race, smoking, coffee drinking and education, analysis showed that past drinkers and very infrequent drinkers had CAD risk similar to that of lifelong abstainers. A significantly and progressively lower CAD risk was found at higher drinking levels. Preference for wine, liquor or beer had no major independent effect. A subset of persons apparently free of CAD and other recent major illnesses showed a similar alcohol-CAD relation. Thus, this study suggests a negative answer to the 4 questions above and supports the view that alcohol protects against CAD. As most of the apparent protection was present at a daily intake of 1 to 2 drinks/day, an amount generally regarded as safe for most persons, the findings should not be used to justify heavier drinking.

Alcohol Drinking↗

Ecto-5'nucleotidase activity in B and T lymphocytes and monocytes of patients with multiple sclerosis.

Ecto-5'nucleotidase activity in the plasma membrane of B and T lymphocytes and cultured and noncultured monocytes from patients with multiple sclerosis and from age- and sex-matched control subjects was determined by radioisotopic assay. The activity on lymphocytes and noncultured monocytes was normal, but the activity on cultured monocytes was found to be higher than normal in 70% of patients with active disease and lower than normal in 85% of patients with chronic inactive disease. Immunofluorescence staining with monoclonal antibodies, carried out in parallel with each assay, did not show any phenotypic differences between each cell population and its control.

5'-Nucleotidase↗

The relationships between alcoholic beverage use and other traits to blood pressure: a new Kaiser Permanente study.

In a new study controlled for many factors, we reconfirmed the relationship of higher blood pressure to alcohol use. This relationship was slightly stronger in men, whites, and persons 55 years of age or older. A slight increase in blood pressure appeared in men who drank one to two drinks daily, and a continuous increase occurred at all higher drinking levels among white men who had constant drinking habits. Among women, an increase occurred only at three or more drinks daily. The data suggest complete regression, beginning within days, of alcohol-associated hypertension upon abstinence. Blood pressure showed minor differences with beverage preference: those who preferred liquor had higher adjusted mean blood pressure than those preferring wine or beer. The results of this study contribute to the likelihood that the alcohol-blood pressure association is causal. Smoking, coffee use, and tea use showed no association with higher blood pressure. Systolic pressure showed a positive relationship to total serum calcium and an inverse relationship to serum potassium, but diastolic pressure showed little relationship to these blood constituents; the explanations include a possible direct effect on regulation of blood pressure.

Adipose Tissue↗

Recognition of host-membrane antigens in the envelope of measles virions.

Trypsin- and acetone-treated virions from either of two strains of measles virus grown in Vero cells stimulated the production in guinea pigs of (i) virus-specific antibodies to polypeptide (P) of molecular weight 70,000 (70K) and to the portion of the HA spike embedded in the viral envelope, but not to M protein, and (ii) antibodies to two host cell membrane antigens which were identified as glycoproteins with molecular weights of 108K and 104K. These host cell antigens were present in increased amounts in infected cells and were intimately associated with the virus. Untreated measles virions grown in Vero cells also stimulated the production of antibody to the 108K glycoprotein. The host polypeptides were less antigenic in virus derived from HEp2 cells, which apparently contained less of these antigens.

Animals↗