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Biomedical subjects

M D Lebowitz

Publications and source records attributed to M D Lebowitz.

At least 127 records · Page 7Linked to original sources
PubMed1984

Family concordance of IgE, atopy, and disease.

Family concordance of IgE was determined in 344 nuclear families that were studied in a community population of white families in the Tucson area. Total circulating IgE, after controlling for age, sex, smoking status, and skin test reactivity demonstrated a significant family concordance with the use of multifactional analysis of variance. This relationship was strongest among siblings, was significant as well between parents and children, and was not present between spouses. Skin test reactivity demonstrated independent family concordance with the same statistical methods. Reported diagnoses of asthma, wheeze, and allergic-rhinitis histories demonstrated a strong concordance of prevalence rates in families as well.

Adult↗
PubMed1984

Influence of passive smoking on pulmonary function: a survey.

A review of the effects of passive smoking on pulmonary function has been made. In children, there is still a great deal of confusion and controversy. The range of the many effects studied is limited; most prospective studies show small effects. In general, it appears that respiratory infections in children may be increased with passive smoking. The effects on children's pulmonary function ranges from 0 to 3% over the age range from conception to 20 years; these differences in absolute magnitude are considered small. In healthy adults, the effects on pulmonary function and symptoms are not considered to be of concern; the effects in asthmatics require further study. A study to evaluate the above effects is presented here. It derives from a prospective study of airway obstructive diseases in Tucson, Arizona. From that study, it was concluded that the effect of passive smoking on pulmonary function or respiratory symptoms (recorded on a daily basis) in children is not positive. Effects may be seen with regard to responses to other irritants in passive-smoking children. In adults, no effect was seen, even in those with asthma or airway obstructive diseases; this may be due to low dosage. It is concluded that further, more appropriate studies are needed to understand the role of passive smoking on pulmonary function.

Adult↗
PubMed1984

Family aggregation of pulmonary function measurements.

Family aggregation of pulmonary function measurements was analyzed in the nuclear families of the Tucson epidemiologic study of airway obstructive diseases (AOD). There were 271 parental pairs and their natural children who had satisfactory pulmonary function data. Initial regression analysis showed significant correlations of the pulmonary function variables after controlling for age and sex. Body habitus, as measured by the Ponderal Index, was highly aggregated as well. Pulmonary function measurements were aggregated in families independent of family size, reported diagnosed AOD, and children's smoking, even though both asthma and smoking showed significant familial aggregation. After controlling for the familial aggregation of body habitus, a major determinant of pulmonary function, there was no remaining independent aggregation of pulmonary function measurements. It was also determined that parental passive smoking had no effect on children's pulmonary function measurements.

Adolescent↗
PubMed1984

Risk of chronic obstructive pulmonary disease. Collaborative assessment of the validity of the Tecumseh index of risk.

Predictors of chronic obstructive pulmonary disease (COPD) have been identified in the prospective epidemiologic study of the population of Tecumseh, Michigan. Risk of developing COPD within 10 yr can be estimated from a profile that includes as risk factors age, sex, cigarette smoking habits, and forced expiratory volume in one second (FEV1). The index of risk placed 63% of male incidence cases and 64% of female incidence cases in the top 10% of the risk distribution and 81% of male and 86% of female COPD cases in the top 20% of the risk distribution for Tecumseh. The validity of the Tecumseh index of risk for other populations was determined in a collaborative investigation of data collected in longitudinal epidemiologic studies in Baltimore, Boston, Framingham, Louisiana, Staveley, and Tucson. The extent to which the risk model fitted these data sets was assessed by comparing predicted (or expected) onsets of COPD in each population with observations made in each study. The predictors of COPD identified in Tecumseh were shown to be the most important risk factors in the other populations as well. The goodness-of-fit of the index was satisfactory overall. In all populations, a high risk score was associated with an increased incidence of COPD, thus confirming the predictive ability of the risk index. The Tecumseh index of risk provides a practical method for developing a risk profile from answers to standard questions and simple tests of lung function. Risks are greatest for heavy cigarette smokers with reduced lung function, lower in smokers who stop smoking or reduce their cigarette consumption, and lowest of all in nonsmokers with above average lung function.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Collaborative study to assess risk of lung disease in Pi MZ phenotype subjects.

We studied 143 Pi MZ heterozygous (MZ) subjects from random populations that had been examined previously for alpha 1-antitrypsin phenotype. Each Pi MZ subject was closely matched with a Pi M control subject from the same population at each of 6 centers. An expanded National Heart, Lung and Blood Institute (NHLBI) respiratory symptom questionnaire was completed by each subject. Pulmonary function tests designed to detect established as well as early obstructive airway abnormalities were administered. Multivariate analysis of the variance of data from the questionnaire and pulmonary function tests corrected for age, race, sex, and smoking history showed no significant difference (p less than 0.05) between subjects of Pi MZ and Pi M phenotype. The size of the populations studied and number of observations made for each variable were sufficient to assure that small differences could be detected with 95% power. We conclude that MZ phenotype alone carries no greater risk of developing lung disease than M phenotype.

Adult↗
PubMed1984

Assessment of air vs helium-oxygen flow-volume curves as an epidemiologic screening test.

Air and helium-oxygen maximum expiratory flow-volume curves were employed in an epidemiologic field study to assess the utility of density dependence as a screening test. Of 1,584 subjects tested, only 54.1 percent were able to perform the test with vital capacities for the two gases that agreed to within 5 percent. Subjects unable to perform the test properly tended to be older, with a greater prevalence of ventilatory function abnormalities and respiratory problems, than those who could perform the test. There was poor concordance between density dependence, or lack thereof, and standard ventilatory function measurements or evidence of respiratory disease. Under field survey conditions, the test of density dependence did not appear to be a useful screening tool.

Adolescent↗
PubMed1983

The effects of pressurized aerosols on respiratory symptoms and physiology.

In a general population sample, use of pressurized aerosols appears to be associated with transient symptoms, but it does not appear to lead to chronic respiratory complaints or to functional abnormalities. This is true in both atopic and non-atopic subjects. Furthermore, changing patterns of aerosol use are not associated with changes in respiratory symptoms. Thus, household and cosmetic aerosols do not appear to be important risk factors for respiratory diseases.

Adolescent↗
PubMed1983

Changes in the normal maximal expiratory flow-volume curve with growth and aging.

On the basis of their answers to a self-administered questionnaire, 697 nonsmoking healthy subjects were chosen from a randomly selected sample representative of the white non-Mexican-American population of Tucson, Arizona, enrolled in a longitudinal study of respiratory health. For each subject, the first satisfactory set of flow-volume data obtained during the first 3 consecutive surveys was selected for analysis. For forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), the single best value for each subject was selected. Other flow-volume measurements were derived from the single test with the best sum FEV, plus FVC. These data were used to derive improved prediction equations for each sex by age group for 5 spirometric and flow-volume variables. The resulting predicted values demonstrate the effects of development, maturation, and senescence on ventilatory function. "Normal" limits are proposed that take into consideration the between-subject variability and non-Gaussian distribution of the various measurements.

Adolescent↗
PubMed1983

Utilization of data from human population studies for setting air quality standards: evaluation of important issues.

Epidemiological studies of community populations are highly relevant to the process of setting national ambient air quality primary standards, as criteria for those standards are the protection of human populations against adverse effects on health. Nevertheless, because of the difficulties of performing adequate community population studies of a quality commensurate with the needs of standard setting, the use of data derived from studies is problematic. This paper addresses the important issues of appropriate exposure assessment and health assessment, and discusses the problems of multiplex variables and colinearity as they are critical in assessments of exposure-effect relationships. It is concluded that a major problem in the use of data from such studies for standard setting is not necessarily one of scientific reliability or validity, but arises from the attempt of translating adequate science into policy decisions.

Air Pollutants↗
PubMed1983

A descriptive analysis of the growth and decline of the FVC and FEV1.

Using data obtained during the first four complete surveys of a general population sample (2,435 spirometric studies on 916 different asymptomatic nonsmoking subjects), we have derived mathematically continuous equations designed to describe the stages of growth, maturation, and subsequent decline in the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC). With this type of analysis, there appears to be a period from late childhood through adolescence in which maturation significantly increases FVC and FEV1 independent of growth, and a stage from late adolescence to the early or mid-30s in which there is relatively little change in these measurements. Progressive decline in FVC and FEV1 may not actually begin until the mid-30s. The mathematical formulae presented here were derived in a manner intended to describe biologic events and are not intended for use as prediction equations. The FEV1/FVC ratio appeared to be primarily a function of the FVC itself in young subjects. After the age of 33 years, FEV1/FVC also decreased with age, independent of the size of the FVC.

Adolescent↗
PubMed1983

Interactions of smoking and immunologic factors in relation to airways obstruction.

The relationships of smoking, allergy skin test reactivity, and serum IgE to ventilatory function have been analyzed in 1,182 subjects from a general population sample. The study group consisted of subjects aged 35 or more who deny previous lung surgery, old tuberculosis, or a current diagnosis of heart disease in the absence of chronic bronchitis or emphysema. Impairment of the forced expiratory volume in one second (FEV1) shows a definite relationship to total serum IgE. However, this relationship is significant only for a low FEV1 which is accompanied by symptoms suggesting asthmatic or a chronic bronchitis type disease. Allergy skin test reactivity to a battery of common aeroallergens shows no overall relationship to FEV1. However, after accounting for total serum IgE, positive allergy skin tests tend to be associated with high rather than low FEV1 values. The findings suggest that some type of IgE which is not specific for aeroallergens but which is associated with smoking, may be important in the pathogenesis of the "chronic asthmatic bronchitis" syndrome.

Adult↗
PubMed1982

Multivariate analysis of smoking and other risk factors for obstructive lung diseases and related symptoms.

Multivariate analyses of the relationship of risk factors and respiratory symptomatology in a longitudinal epidemiologic study of airways obstructive disease in a white community population has yielded some consistent findings. Diagnosed airway obstructive diseases and functional impairment appear to be related to a set of risk factors which include age, smoking, a history of acute respiratory illness, chronic cough and phlegm, and to some extent, social status, occupational exposures, and alcohol consumption. Smoking definitely appears to be related to productive cough. It also appears to be related, though not necessarily directly, to AOD and lung function impairment. The complexity of the relationships were clarified by the analysis using multivariate techniques.

Adolescent↗
PubMed1982

The relationship of serum immunoglobulin E, allergy skin tests, and smoking to respiratory disorders.

In this study of a general population sample in Tucson, Ariz., smokers showed higher levels of serum IgE despite having a lower rate of allergy skin-test reactivity to common aeroallergens than nonsmokers. The prevalence of rhinitis was closely related to the level of serum IgE in atopic subjects regardless of smoking habits. In nonatopic smokers, elevated IgE levels were not associated with high rhinitis rates. However, high IgE levels in nonatopic smokers were related to increased rates of diagnosed asthma, wheeze, and chronic cough and/or sputum (C/S). These relationships were especially striking in subjects over the age of 54. In older nonatopic smokers, reported prevalences of "chronic bronchitis" and of functional impairment also increased in relation to the level of serum IgE. Reduced ventilatory function showed this relationship to IgE only when accompanied by C/S. It is suggested that the excess IgE related to smoking is qualitatively different than that found in subjects reacting to aeroallergens, is not important in the pathogenesis of upper respiratory tract disease, but may play a role in the development of some lower respiratory tract disorders.

Adolescent↗