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Biomedical subjects

M Higgins

Publications and source records attributed to M Higgins.

At least 91 records · Page 5Linked to original sources
PubMed1991

Reduction of cardiovascular disease-related mortality among postmenopausal women who use hormones: evidence from a national cohort.

A national sample of 1944 white menopausal women greater than or equal to 55 years old from the epidemiologic follow-up of participants in the National Health and Nutrition Examination Survey was reviewed to investigate the role of hormone therapy in altering the risk of death from cardiovascular disease. Women in the study were observed for up to 16 years after the baseline survey in 1971 to 1975. By 1987 631 women had died; 347 of these deaths were due to cardiovascular disease. History of diabetes (relative risk, 2.38; 95% confidence interval 1.73 to 3.26), previous myocardial infarction (relative risk, 2.12; 95% confidence interval 1.56 to 2.86), smoking (relative risk, 2.18; 95% confidence interval, 1.69 to 2.81), and elevated blood pressure (relative risk, 1.49; 95% confidence interval, 1.14 to 1.94) were strong predictors of cardiovascular disease-related death in this cohort. After adjusting for known cardiovascular disease risk factors (smoking, cholesterol, body mass index, blood pressure, previous myocardial infarction, history of diabetes, age) and education, the use of postmenopausal hormones was associated with a reduced risk of death from cardiovascular disease (relative risk, 0.66; 95% confidence interval, 0.48 to 0.90). The same protective effect provided by postmenopausal hormone therapy was seen in women who experienced natural menopause (relative risk, 0.69; 95% confidence interval, 0.45 to 1.06).

Cardiovascular Diseases↗
PubMed1991

Risk factors associated with chronic obstructive lung disease.

Chronic obstructive lung disease (COLD) includes emphysema, chronic airways obstruction, and chronic bronchitis but not asthma. COLD mortality and morbidity rates are higher in men than women, in whites than blacks, and they increase with increasing age and with decreasing socioeconomic status. Death rates for COLD are approximately 10 times higher in cigarette smokers than in nonsmokers, and about 80% of COLD deaths in the United States are attributable to cigarette smoking. Among smokers, the quantity and duration of cigarette use are strongly related to mortality and morbidity, but susceptibility varies among individuals. Incidence of COLD is related inversely to pulmonary function and possibly to increased bronchial reactivity. Alpha 1-antiprotease deficiency, respiratory infections and symptoms, lean body build, and exposures to occupational hazards or air pollution have been associated with increased risks of COLD in epidemiologic and clinical studies. Susceptible individuals can reduce their risks of clinical disease by stopping smoking. Clinical trials are underway to determine whether bronchodilators reduce the rates of decline in pulmonary function.

Adult↗
PubMed1991

Pulmonary function and cardiovascular risk factor relationships in black and in white young men and women. The CARDIA Study.

Pulmonary function is known to be related inversely to incidence of coronary heart disease, congestive heart failure, chronic obstructive lung disease, lung cancer, and death from all causes. Reasons for some of these associations are poorly understood. Relationships between cardiovascular disease risk factors and pulmonary function were examined in 5,115 18- to 30-year-old black and white male and female participants in the study of Coronary Artery Risk Development in Young Adults (CARDIA). Forced expiratory volume in 1 s adjusted for height (FEV1/Ht2) was significantly lower in smokers than nonsmokers and in persons who reported shortness of breath; FEV1/Ht2 was correlated positively with a history of strenuous physical activity, duration of exercise on the treadmill, and high-density lipoprotein cholesterol. It was associated negatively with skinfold thicknesses, serum triglycerides, fasting serum insulin, and the Cook Medley scale of hostility. The association between pulmonary function and heart disease risk may reflect associations with physical fitness, vigor, fatness, and lipid profiles, as well as with cigarette smoking.

Adolescent↗
PubMed1991

[Demographic trends and the burden of cardiovascular diseases].

The current burden of cardiovascular disease in the U.S. population and recent trends in morbidity, mortality and risk factors provide a perspective on heart disease in the 21st century. Projections of demographic trends for populations and predictions of the frequency, distribution and characteristics of cardiovascular disease in the future are offered with numerous reservations and subject to revision. Nonetheless, we can expect to see more patients with cardiovascular disease in the next few decades and these patients are likely to be older and to be from the less well-educated and poorer socioeconomic segments of society. Improvements in treatment for the initial cardiovascular event may result in increased survival of women and men suffering permanent damage or disability. There will also be better opportunities to prevent cardiovascular diseases through modifying risk factors in the general population and in high risk individuals. Non-invasive procedures will also increase opportunities for detecting and reversing preclinical atherosclerosis through hygienic and therapeutic measures.

Cardiovascular Diseases↗
PubMed1990

Subcellular biodistribution of 99Tcm(V) DMSA in squamous carcinoma: a comparative study in humans and in an animal tumour model.

Technetium-99m(99Tcm) (V) dimercaptosuccinic acid is a new imaging agent which has been used to evaluate head and neck squamous cell carcinoma (SCC). This study compared the subcellular biodistribution of 99Tcm(V)DMSA in an established rabbit tumour SCC model and in humans with head and neck SCC. In rabbits, approximately 17-37% of radioactivity was located on tumour cell membrane. Approximately 57-80% of radioactivity was located nonspecifically in tumour cytosol, only 2-6% was bound specifically to tumour mitochondria, and 1-4% bound specifically to microsomes. In humans, 25-45% of radioactivity was localized on tumour cell membrane and 28-60% localized nonspecifically in tumour cytosol. There was 11-20% of radioactivity specifically bound inside the cell to the mitochondria and 1-6% specifically bound to microsomes. These results show that although 99Tcm(V)DMSA is accumulated at sites of SCC, the localization process is nonspecific.

Aged↗
PubMed1990

What happens to patients after five years of intensive case management stops?

Seventy-two patients who received five years of intensive case management services were transferred into mainstream community mental health center services with a much higher patient-to-staff ratio. At the end of a two-year follow-up, 91 percent of the patients were still receiving treatment. Compared with the previous five years, hospitalizations during the follow-up period increased, but not significantly so. Contacts with mainstream CMHC services increased significantly. Overall costs in constant 1979 dollars showed a nonsignificant decrease, dropping by about $1,500 per patient per year. The staff time and resources gained by the programmatic changes were used to treat a larger number of chronic patients seeking services.

Adult↗
PubMed1990

Smoking and hypertension as predictors of cardiovascular risk in population studies.

Hypertension is a powerful independent contributor to cardiovascular morbidity and mortality, on average conferring a threefold increase in risk at all ages and in both sexes. Coronary heart disease is now the chief lethal sequela of hypertension, occurring at a rate two to three times higher in hypertensives than in normotensives. The risk of cardiovascular morbidity and mortality is also greatly affected by cigarette smoking. For each 10 cigarettes per day there is an incremental increase in cardiovascular mortality in men (18%) and in women (31%). The risk of coronary heart disease that is associated with hypertension varies over an eightfold range depending on coexistent risk factors. Smoking increases the cardiovascular risk, at any level of blood pressure, for coronary heart disease, stroke and cardiac failure. The risk of peripheral arterial disease is particularly adversely affected. Trials of antihypertensive therapy to reduce the coronary heart disease risk have yielded disappointing results, very likely because of failure to correct for blood lipids and cigarette smoking. These trials have consistently shown that cigarette smoking has a powerful effect on the risk of coronary heart disease whether the patients were treated for hypertension or not. Data from the Framingham Study have shown a prompt halving of the coronary heart disease risk in those who give up smoking compared to those who continue to smoke, regardless of the duration of the habit. Hypertensives who smoke one pack of cigarettes a day can quickly reduce the risk by 35-40% by not smoking. Switching to filter cigarettes offers no advantage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Endocytosis of horseradish peroxidase-poly-lysine conjugate by glomerular epithelial cells: an in vivo study.

Native horseradish peroxidase (HRP) is known to pass rapidly through glomeruli when injected into rats. We have found that a conjugate of HRP with poly-lysine is readily endocytosed by glomerular epithelial cells (GEC). We have used this conjugate to study the GEC endocytotic process in male Wistar rats. The conjugate has an approximate molecular weight of 55-58,000, a pI of greater than 10.0, and almost the same secondary conformation as HRP; it does not increase urinary protein excretion significantly or alter the morphology of the renal glomeruli. After intravenous injection of the conjugate, it could be found in the GBM from 1 min to 4 h. At 1 min, it was evenly distributed on GEC foot processes and plasma membrane. GEC start to take up the conjugate from 1 min post-injection, by cellular membrane invagination. This reached a maximum at 4 h. Some of the endocytosed conjugate passed to lysosomes from the endosomal system. The amount of peroxidase demonstrable in the glomerular epithelial cells was considerably reduced by 24 h.

Animals↗
PubMed1989

Buoyant density, growth rate, and the cell cycle in Streptococcus faecium.

The buoyant density in rapidly growing Streptococcus faecium 9790 cells varies over the cell cycle, in contrast to the density in Escherichia coli. Buoyant density in S. faecium was measured by using Percoll (Pharmacia Fine Chemicals, Piscataway, N.J.) density gradients. We found that the mean and coefficient of variation of the population density increased with growth rate; and within a population, the mean cell volume, which was measured electronically, increased with density. These results were compared with electron microscopic measurements of the size distributions of cell wall growth sites within each fraction of the density gradient. As the density increased within a population, the frequency of large cells increased and the frequency of newly initiated cell wall growth sites increased. These effects were more marked as the growth rate increased. Next, these data were regrouped by cell size by using the size of the central growth site as an index of cell cycle stage. Each frequency value was weighted by the proportion of the population represented by that density fraction. Then, the average buoyant density was calculated for each value of cell size. In all cell populations, the density decreased and then increased as the central site enlarged. Peripheral growth sites were initiated as density reached a maximum. At faster growth rates, density increased more steeply, and new peripheral growth sites opened up at a higher frequency. We suggest that the rate at which density increases during the cell cycle correlates with the initiation of new cell wall growth sites.

Cell Cycle↗
PubMed1989

Variation in buoyant density of whole cells and isolated cell walls of Streptococcus faecium (ATCC 9790).

The buoyant density of whole cells of Streptococcus faecium varies with growth rate and during the cell cycle. Two possible explanations for this were explored: (i) the density of cell walls may vary, and (ii) the proportions of wall and cytoplasm may vary. We tested the first possibility by isolating walls from chilled, unfixed populations of S. faecium cells and fractionating them on Percoll density gradients. Mean cell wall density averaged 4% less than whole-cell density and did not vary significantly with growth rate. In addition, walls isolated from heavy and light fractions of a population of cells did not differ significantly in density. Thus, variation in the density of isolated cell walls could not account for the observed variation in whole-cell density within or between populations. Using previously published measurements of the physical dimensions of S. faecium cells, we also found that the relative proportions of wall and cytoplasm (see the second possibility above) could not account for the observed changes in whole-cell buoyant density.

Cell Wall↗
PubMed1989

Trends in CHD in the United States.

Coronary heart disease (CHD) death rates increased in the United States until the mid 1960s then declined. Declines were greater for acute myocardial infarction (AMI), for younger age groups, for the white population, and for higher socioeconomic groups. Trends in incidence are uncertain but in-hospital fatality rates have decreased. There have been major advances in diagnosis, prevention and treatment of CHD, and numbers of internists and cardiologists, emergency medical services, and coronary care units have increased. New potent medical and surgical treatments for acute and chronic CHD have been introduced. Reductions in risk factors include decreases in cigarette smoking especially among men, falls in mean systolic blood pressure, rises in the proportion of hypertensive adults who are treated and controlled, and reductions in plasma cholesterol. Consumption of whole milk, butter, and eggs decreased whereas use of low fat milk, cooking oils, poultry, fish, vegetables, and fruits increased. However, the prevalence of obesity has increased. CHD is still the leading cause of death, and its prevalence is expected to rise as the population increases at older ages and treatment prolongs survival of patients with CHD.

Adult↗
PubMed1988

Body mass index and mortality among nonsmoking older persons. The Framingham Heart Study.

The relationship of weight at age 65 years and subsequent mortality was examined in a population of 1723 nonsmokers who were followed up from one to 23 years (mean, 9.5 years) during the Framingham Heart Study. In sex-specific proportional hazards analyses, risks of mortality were increased for men and women at the high and low extremes of body mass index, even when accounting for potential effects of excess weight on serum cholesterol level, blood glucose level, and systolic blood pressure. For those at the lower extreme of body mass index, the relative risk of death was almost twice as high in the years immediately after age 65 years as in later follow-up, suggesting that the increased early death rate was due to disease that was already present. At the upper extreme, risk of death was twofold over the entire follow-up period for persons with body mass indexes at or above the 70th percentile at both 55 and 65 years of age. We conclude that, even when accounting for cardiovascular risk factors, being overweight is a serious health problem for older people, especially for those with long-standing weight problems.

Aged↗
PubMed1988

Hazards of obesity--the Framingham experience.

Measurements of height, weight, skinfolds and waist girth were used as indicators of general and regional obesity in the Framingham study population of 5,209 men and women. Mean values of cholesterol, blood pressure, blood glucose and uric acid increased with increasing body mass index (BMI). Weight gain was associated with increases and weight loss with decreases in these risk factors. Cigarette smoking was more prevalent in men and women with low quintile BMI. Upper quintile values of BMI, subscapular skinfolds, and waist girth were associated with increased relative risks of death from all causes, coronary heart disease (CHD) and cerebrovascular disease but relative risks for intermittent claudication were not increased. General and central obesity each made independent contributions to risk of CHD but central obesity was a better predictor in males. BMI, cholesterol, systolic blood pressure and blood glucose were significantly independent predictors of CHD. These data show that increased relative weight and central obesity are associated with elevated levels of risk factors, with increased incidence of cardiovascular disease and with increased death rates for all causes combined. Mortality rates are also increased among the leanest members of the population, especially among older men.

Adipose Tissue↗
PubMed1987

Obesity and hypertension: epidemiological and clinical issues.

The relationship between obesity and hypertension has been investigated in a large number of cross-sectional population studies and a smaller number of prospective, observational studies. The results indicate that in most populations, blood pressure increases linearly with increasing body weight or body mass index. The relationship is present across all subgroups, although the magnitude of the association appears greater in whites than blacks and greater in younger than older persons. It is estimated that as much as one-third of all hypertension may be attributable to obesity in populations where hypertension and obesity are widely prevalent. Evidence from prospective studies and clinical trials suggests that hypertension in obese patients increases the risk of cardiovascular disease and that drug treatment of hypertension reduces the risk. However, it is uncertain whether the risks associated with hypertension and the benefits of treatment are as great in obese hypertensives as they are in lean hypertensives. The effects of weight reduction on blood pressure have been investigated in a small number of randomized, controlled trials involving a total of about 600 participants. Overall, the results of the trials indicate that weight reduction lowers blood pressure over intervals of up to one year. The magnitude of the blood pressure response appears to be directly proportional to the amount of weight loss achieved. However, the latter is inversely related to the length of follow-up. Adequate maintenance of weight loss remains a major problem for the much-needed, long-term trials of the effects of weight reduction on blood pressure and the cardiovascular complications of hypertension.

Adult↗
PubMed1984

The Nance-Horan syndrome: a rare X-linked ocular-dental trait with expression in heterozygous females.

This report describes two families with the Nance-Horan syndrome, an X-linked trait featuring lenticular cataracts and anomalies of tooth shape and number. Previous reports have described blindness in affected males but posterior sutural cataracts with normal vision as the primary ocular expression in heterozygous females. In one of these two families, the affected female is not only blind in one eye but reportedly had supernumerary central incisors (mesiodens) removed. This constitutes the most severe ocular and dental expression of this gene in heterozygous females yet reported.

Adult↗