PubMed Health⌕ Search

Biomedical subjects

M Hollander

Publications and source records attributed to M Hollander.

At least 19 recordsLinked to original sources
PubMed2006

Unrecognized myocardial infarction and the risk of stroke: the Rotterdam Study.

OBJECTIVE: To investigate the relationship between unrecognized myocardial infarction and the risk of stroke in a population-based cohort study. METHODS: We followed 6,439 participants from the Rotterdam Study for stroke until January 2002. Participants were free from stroke, and presence of myocardial infarction was assessed at baseline (1990-1993). We calculated hazard ratios of stroke for persons with unrecognized or recognized myocardial infarction compared with persons without myocardial infarction. Analyses were adjusted for age, sex, and cardiovascular risk factors. RESULTS: In 52,915 person-years of follow-up, 505 strokes occurred. Recognized myocardial infarction was only borderline associated with an increased risk of stroke. Unrecognized myocardial infarction increased the risk of stroke by 76% (age- and sex-adjusted hazard ratio 1.76, 95% CI 1.31 to 2.37). Stratification by sex showed that the increased risk was only found in men (hazard ratio for men 2.53, 95% CI 1.68 to 3.81; hazard ratio for women 1.27, 95% CI 0.82 to 1.96). After adjusting for cardiovascular risk factors at baseline, the risk remained significantly increased in men (hazard ratio for stroke 2.13, 95% CI 1.35 to 3.36). Subtyping of strokes revealed that unrecognized myocardial infarction was particularly associated with cortical ischemic strokes (hazard ratio for men 3.57, 95% CI 1.79 to 7.12). CONCLUSIONS: Men with unrecognized myocardial infarction have an increased risk of stroke.

Age Distribution↗
PubMed2003

Dietary antioxidants and the risk of ischemic stroke: the Rotterdam Study.

In the Rotterdam Study, the authors investigated whether high intake of antioxidants from food is associated with the risk of stroke. Among 5,197 participants who were followed on average for 6.4 years, 227 ischemic strokes occurred. Higher intake of antioxidants was associated with a lower risk of stroke. The relationship was dose-dependent, significant for vitamin C, and most pronounced in smokers. These results agree with the view that high dietary intake of antioxidants, in particular vitamin C and--in smokers--vitamin E, reduces the risk of stroke.

Aged↗
PubMed2003

Comparison between measures of atherosclerosis and risk of stroke: the Rotterdam Study.

BACKGROUND AND PURPOSE: Several measures of atherosclerosis predict the risk of stroke. However, a comparison between various measures of atherosclerosis is lacking, and limited information exists on the added value of individual measures of atherosclerosis to cardiovascular risk factors. We compared different measures of atherosclerosis in relation to stroke. METHODS: The study was based on the prospective cohort of the Rotterdam Study and included 6913 participants who did not suffer from previous stroke. At baseline, carotid intima-media thickness and plaques, ankle-arm index, and aortic calcifications were assessed; 3996 participants (53%) had measures of all studied markers of atherosclerosis. After a mean follow-up of 6.1 years, 378 strokes occurred. Data were analyzed with Cox proportional-hazards regression and Akaike information criteria scores. RESULTS: Carotid intima-media thickness and aortic calcifications were related most strongly to the risk of stroke (relative risk, 2.23 and 1.89; 95% confidence interval, 1.48 to 3.36 and 1.28 to 2.80 for highest versus lowest tertile, respectively). The relations between intima-media thickness, aortic calcifications, and carotid plaques and stroke remained after adjustment for cardiovascular risk factors. Intima-media thickness and aortic calcifications were related to the risk of stroke independently of each other. The relation between ankle-arm index and stroke disappeared after adjustment for cardiovascular risk factors. CONCLUSIONS: Carotid intima-media thickness and aortic calcifications are stronger predictors of incident stroke than carotid plaque or ankle-arm indexes. They have additional value to each other and to classic risk factors and may reflect different processes.

Aged↗
PubMed2003

Incidence, risk, and case fatality of first ever stroke in the elderly population. The Rotterdam Study.

OBJECTIVE: To estimate the incidence, survival, and lifetime risk of stroke in the elderly population. METHODS: The authors conducted a study in 7,721 participants from the population based Rotterdam Study who were free from stroke at baseline (1990-1993) and were followed up for stroke until 1 January 1999. Age and sex specific incidence, case fatality rates, and lifetime risks of stroke were calculated. RESULTS: Mean follow up was 6.0 years and 432 strokes occurred. The incidence rate of stroke per 1,000 person years increased with age and ranged from 1.7 (95% CI 0.4 to 6.6) in men aged 55 to 59 years to 69.8 (95% CI 22.5 to 216.6) in men aged 95 years or over. Corresponding figures for women were 1.2 (95% CI 0.3 to 4.7) and 33.1 (95% CI 17.8 to 61.6). Men and women had similar absolute lifetime risks of stroke (21% for those aged 55 years). The survival after stroke did not differ according to sex. CONCLUSIONS: Stroke incidence increases with age, also in the very old. Although the incidence rate is higher in men than in women over the entire age range, the lifetime risks were similar for both sexes.

Aged↗
PubMed2002

Carotid plaques increase the risk of stroke and subtypes of cerebral infarction in asymptomatic elderly: the Rotterdam study.

BACKGROUND: Few studies have quantified the relation between carotid plaques and stroke in asymptomatic patients, and limited data exist on the importance of location of plaques or the association with subtypes of cerebral infarction. We investigated the relationship between carotid plaques, measured at different locations, and risk of stroke and subtypes of cerebral infarction in a population-based study. Methods and Results- The study was based on the Rotterdam Study and included 4217 neurologically asymptomatic subjects aged 55 years or older. Presence of carotid plaques at 6 locations in the carotid arteries was assessed at baseline. Severity was categorized according to the number of affected sites. After a mean follow-up of 5.2 years, 160 strokes had occurred. Data were analyzed using Cox proportional hazards regression. Plaques increased the risk of stroke and cerebral infarction approximately 1.5-fold, irrespective of plaque location. Severe carotid plaques increased the risk of nonlacunar infarction in anterior (RR 3.2 [95% CI, 1.1 to 9.7]) but not in posterior circulation (RR 0.6 [95% CI, 0.1 to 4.9]). A >10-fold increased risk of lacunar infarction was found in subjects with severe plaques (RR 10.8 [95% CI, 1.7 to 69.7]). No clear difference in risk estimates was seen between ipsilateral and contralateral infarction. CONCLUSIONS: Carotid plaques increase the risk of stroke and cerebral infarction, irrespective of their location. Plaques increase the risk of infarctions in the anterior but not in the posterior circulation. It is likely that carotid plaques in neurologically asymptomatic subjects are both markers of generalized atherosclerosis and sources of thromboemboli.

Aged↗
PubMed2001

Is carotid intima-media thickness useful in cardiovascular disease risk assessment? The Rotterdam Study.

BACKGROUND AND PURPOSE: We determined the contribution of common carotid intima-media thickness (IMT) in the prediction of future coronary heart disease and cerebrovascular disease when added to established risk factors. METHODS: We used data from a nested case-control study comprising 374 subjects with either an incident stroke or a myocardial infarction and 1496 controls. All subjects were aged 55 years and older and participated in the Rotterdam Study. Mean follow-up was 4.2 years (range, 0.1 to 6.5 years). We evaluated which correlates of coronary heart disease and cerebrovascular disease contribute to the prediction of either a new incident myocardial infarction or a stroke. Logistic regression modeling and the area under the receiver operating characteristic curve (ROC area) were used to quantify the predictive value of the established risk factors and the added value of IMT. RESULTS: The ROC area of a model with age and sex only was 0.65 (95% CI, 0.62 to 0.69). Independent risk factors were previous myocardial infarction and stroke, diabetes mellitus, smoking, systolic blood pressure, diastolic blood pressure, and total and HDL cholesterol levels. These risk factors increased the ROC area from 0.65 to 0.72 (95% CI, 0.69 to 0.75). This model correctly predicted 17% of all subjects with coronary heart disease and cerebrovascular disease. When common carotid IMT was added to the previous model, the ROC area increased to 0.75 (95% CI, 0.72 to 0.78). When only the IMT measurement was used, the ROC area was 0.71 (95% CI, 0.68 to 0.74), and 14% of all subjects were correctly predicted. There was no difference in ROC area when different measurement sites were used. CONCLUSIONS: Adding IMT to a risk function for coronary heart disease and cerebrovascular disease does not result in a substantial increase in the predictive value when used as a screening tool.

Aged↗
PubMed1999

Is the prevalence of HIV-associated nephropathy decreasing?

Initial reports have suggested that approximately 10% of patients with HIV-infection develop HIV-associated nephropathy (HIVAN). It has also been predicted that by the end of the decade, HIVAN is likely to become a third leading cause of end-stage renal disease (ESRD) in African-Americans between the ages of 20-64 years. As the morbidity and mortality from HIV-infection has decreased in the last few years, it is possible that prevalence of HIVAN is also changing. We therefore screened HIV-1-infected patients followed in our hospital for HIVAN. A screening urinalysis was performed in 557 HIV-1-infected adult patients between March and May 1998. Of these, 252 were outpatients and 305 were Texas Department of Criminal Justice inmates (TDCJI). Demographic and laboratory data of these patients was obtained from the HIV patients' database. Fifty percent of the patients were African-American, 36.6% were Caucasian and 12. 7% were Hispanic. The mean age of patients was 37 +/- 8 years. Seventy-nine percent of the patients were males and a history of intravenous drug abuse (IVDA) was present in 28%. Twenty-three percent of the patients were concomitantly infected with hepatitis C virus, 4.1% were positive for hepatitis B surface antigen, and rapid plasma reagin test for syphilis was positive in 9.1%. In 38 patients who had more than 100 mg/dl (2+) proteins on screening urinalysis, total urinary proteins were quantitated by collecting 24 h urine specimens. Fifteen of these patients had urinary proteins more than 1.5 g/day (12 patients >3.5 g/24 h and 3 patients >1.5 g/24 h). A renal biopsy was done in 14 of these patients and clinical diagnosis of HIVAN was made in one patient who refused biopsy. Renal biopsies revealed HIVAN [9], diabetic nephropathy [2], membranoproliferative glomerulonephritis [2], Fibrillary glomerulonephritis [1]. All 10 patients (5 TDCJI and 5 outpatients) with HIVAN were African-American. Two of these 10 patients had a history of IVDA and another two were concomitantly infected with hepatitis C virus. The plasma viral load (Pvl) and total CD4 count was not different in patients with or without HIVAN [(Pvl log 10.05 +/- 1.39 vs. 9.9 +/- 2.18 copies/ml, p = 0.78) (CD4: 187 +/- 192 vs. 288 +/- 249 cells/microl, p = 1.17) mean +/- SD]. We conclude that in our HIV-infected population HIVAN exclusively affected African-Americans and the prevalence in them was 3.5%.

AIDS-Associated Nephropathy↗
PubMed1997

Financing long-term care in Canada.

Financial policies relating to long-term care in Canada are changing rapidly in response to demands for health care reform. This chapter focuses on the financial structure of institutional care, primarily nursing homes, in the western provinces of Alberta and British Columbia. Community-based long-term care is discussed briefly.

Activities of Daily Living↗
PubMed1996

Young children's understanding of thought bubbles and of thoughts.

In a series of 4 studies, we explored preschoolers' understanding of thought bubbles. Very few 3-year-olds or 4-year-olds we tested knew what a thought-bubble depiction was without instruction. But, if simply told that the thought bubble "shows what someone is thinking," the vast majority of 3-year-olds and 4-year-olds easily understood the devices as depicting thoughts generally and individual thought contents specifically. In total, these children used thought-bubble depictions to ascertain the contents of characters' thoughts in a variety of situations; appropriately distinguished such depictions from mere associated actions or objects; described thought bubbles in the language of mental states; judged that persons' thoughts in these depictions were subjective in the sense of person-specific (and hence 2 people can have different thoughts about the same state of affairs); and judged that thought-bubble thoughts (a) were representational in the sense of depicting or showing some other state of affairs, (b) were mental and thus showed intangible, private, internal thoughts unlike real pictures or photographs, and (c) can be false, that is, can depict a person's misrepresentation of some state of affairs. We discuss the implications of these findings for young children's understanding of thoughts and thought bubbles, for their learning and comprehension of pictorial conventions, and for the use of thought bubbles to assess children's early understanding of mind.

Attention↗
PubMed1995

Dynamic reliability models with conditional proportional hazards.

A dynamic approach to the stochastic modelling of reliability systems is further explored. This modelling approach is particularly appropriate for load-sharing, software reliability, and multivariate failure-time models, where component failure characteristics are affected by their degree of use, amount of load, or extent of stresses experienced. This approach incorporates the intuitive notion that when a set of components in a coherent system fail at a certain time, there is a 'jump' from one structure function to another which governs the residual lifetimes of the remaining functioning components, and since the component lifetimes are intrinsically affected by the structure function which they constitute, then at such a failure time there should also be a jump in the stochastic structure of the lifetimes of the remaining components. For such dynamically-modelled systems, the stochastic characteristics of their jump times are studied. These properties of the jump times allow us to obtain the properties of the lifetime of the system. In particular, for a Markov dynamic model, specific expressions for the exact distribution function of the jump times are obtained for a general coherent system, a parallel system, and a series-parallel system. We derive a new family of distribution functions which describes the distributions of the jump times for a dynamically-modelled system.

Computer Systems↗
PubMed1994

Sensitivity of children's inflection to grammatical structure.

What is the input to the mental system that computes inflected forms like walked, came, dogs, and men? Recent connectionist models feed a word's phonological features into a single network, allowing it to generalize both regular and irregular phonological patterns, like stop-stopped, step-stepped and fling-flung, cling-clung. But for adults, phonological input is insufficient: verbs derived from nouns like ring the city always have regular past tense forms (ringed), even if they are phonologically identical to irregular verbs (ring the bell). Similarly, nouns based on names, like two Mickey Mouses, and compounds based on possessing rather than being their root morpheme, such as two sabertooths, take regular plurals, even when they are homophonous with irregular nouns like mice and teeth. In four experiments, testing 70 three- to ten-year-old children, we found that children are sensitive to such nonphonological information: they were more likely to produce regular inflected forms for forms like to ring ('to put a ring on') and snaggletooth (a kind of animal doll with big teeth) than for their homophonous irregular counterparts, even when these counterparts were also extended in meaning. Children's inflectional systems thus seem to be like adults': irregular forms are tied to the lexicon but regular forms are computed by a default rule, and words are represented as morphological tree structures reflecting their derivation from basic word roots. Such structures, which determine how novel complex words are derived and interpreted, also govern whether words with irregular sound patterns will be regularized: a word can be irregular only if its structure contains an irregular root in 'head' position, allowing the lexically stored irregular information to percolate up to apply to the word as a whole. In all other cases, the inflected form is compouted by a default regular rule. This proposal fits the facts better than alternatives appealing to ambiguity reduction or semantic similarity to a word's central sense. The results, together with an analysis of adult speech to children, suggest that morphological structure and a distinction between mechanisms for regular and irregular inflection may be inherent to the design of children's language systems.

Child↗
PubMed1992

Overregularization in language acquisition.

Children extend regular grammatical patterns to irregular words, resulting in overregularizations like comed, often after a period of correct performance ("U-shaped development"). The errors seem paradigmatic of rule use, hence bear on central issues in the psychology of rules: how creative rule application interacts with memorized exceptions in development, how overgeneral rules are unlearned in the absence of parental feedback, and whether cognitive processes involve explicit rules or parallel distributed processing (connectionist) networks. We remedy the lack of quantitative data on overregularization by analyzing 11,521 irregular past tense utterances in the spontaneous speech of 83 children. Our findings are as follows. (1) Overregularization errors are relatively rare (median 2.5% of irregular past tense forms), suggesting that there is no qualitative defect in children's grammars that must be unlearned. (2) Overregularization occurs at a roughly constant low rate from the 2s into the school-age years, affecting most irregular verbs. (3) Although overregularization errors never predominate, one aspect of their purported U-shaped development was confirmed quantitatively: an extended period of correct performance precedes the first error. (4) Overregularization does not correlate with increases in the number or proportion of regular verbs in parental speech, children's speech, or children's vocabularies. Thus, the traditional account in which memory operates before rules cannot be replaced by a connectionist alternative in which a single network displays rotelike or rulelike behavior in response to changes in input statistics. (5) Overregularizations first appear when children begin to mark regular verbs for tense reliably (i.e., when they stop saying Yesterday I walk). (6) The more often a parent uses an irregular form, the less often the child overregularizes it. (7) Verbs are protected from overregularization by similar-sounding irregulars, but they are not attracted to overregularization by similar-sounding regulars, suggesting that irregular patterns are stored in an associative memory with connectionist properties, but that regulars are not. We propose a simple explanation. Children, like adults, mark tense using memory (for irregulars) and an affixation rule that can generate a regular past tense form for any verb. Retrieval of an irregular blocks the rule, but children's memory traces are not strong enough to guarantee perfect retrieval. When retrieval fails, the rule is applied, and overregularization results.

Age Factors↗
PubMed1991

Affectedness and direct objects: the role of lexical semantics in the acquisition of verb argument structure.

How do speakers predict the syntax of a verb from its meaning? Traditional theories posit that syntactically relevant information about semantic arguments consists of a list of thematic roles like "agent", "theme", and "goal", which are linked onto a hierarchy of grammatical positions like subject, object and oblique object. For verbs involving motion, the entity caused to move is defined as the "theme" or "patient" and linked to the object. However, this fails for many common verbs, as in fill water into the glass and cover a sheet onto the bed. In more recent theories verbs' meanings are multidimensional structures in which the motions, changes, and other events can be represented in separate but connected substructures; linking rules are sensitive to the position of an argument in a particular configuration. The verb's object would be linked not to the moving entity but to the argument specified as "affected" or caused to change as the main event in the verb's meaning. The change can either be one of location, resulting from motion in a particular manner, or of state, resulting from accommodating or reacting to a substance. For example, pour specifies how a substance moves (downward in a stream), so its substance argument is the object (pour the water/glass); fill specifies how a container changes (from not full to full), so its stationary container argument is the object (fill the glass/water). The newer theory was tested in three experiments. Children aged 3;4-9;4 and adults were taught made-up verbs, presented in a neutral syntactic context (this is mooping), referring to a transfer of items to a surface or container. Subjects were tested on their willingness to encode the moving items or the surface as the verb's object. For verbs where the items moved in a particular manner (e.g., zig-zagging), people were more likely to express the moving items as the object; for verbs where the surface changed state (e.g., shape, color, or fullness), people were more likely to express the surface as the object. This confirms that speakers are not confined to labeling moving entities as "themes" or "patients" and linking them to the grammatical object; when a stationary entity undergoes a state change as the result of a motion, it can be represented as the main affected argument and thereby linked to the grammatical object instead.

Attention↗
PubMed1991

Syntax and semantics in the acquisition of locative verbs.

Children between the ages of three and seven occasionally make errors with locative verbs like pour and fill, such as *I filled water into the glass and *I poured the glass with water (Bowerman, 1982). To account for this pattern of errors, and for how they are eventually unlearned, we propose that children use a universal linking rule called object affectedness: the direct object corresponds to the argument that is specified as 'affected' in some particular way in the semantic representation of a verb. However, children must learn which verbs specify which of their arguments as being affected; specifically, whether it is the argument whose referent is undergoing a change of location, such as the content argument of pour, or the argument whose referent is undergoing a change of state, such as the container argument of fill. This predicts that syntactic errors should be associated with specific kinds of misinterpretations of verb meaning. Two experiments were performed on the ability of children and adults to understand and produce locative verbs. The results confirm that children tend to make syntactic errors with sentences containing fill and empty, encoding the content argument as direct object (e.g. fill the water). As predicted, children also misinterpreted the meanings of fill and empty as requiring not only that the container be brought into a full or empty state, but also that the content move in some specific manner (by pouring, or by dumping). Furthermore, children who misinterpreted the verbs' meanings were more likely to make syntactic errors with them. These findings support the hypothesis that verb meaning and syntax are linked in precise ways in the lexicons of language learners.

Child↗
PubMed1989

Managing noncompliance in a schizophrenic patient with chronic skin disorders.

A schizophrenic-diagnosed woman with a long-term history of scratching and skin problems was referred for behavioral treatment because she was not responding well to medical care and was often described as noncompliant. The treatment of noncompliance consisted of four phases: (I) direct habit modification, (II) compliance training, (III) controlling anxiety precipitants and (IV) follow-up monitoring and evaluation. After several months of treatment, the maladaptive behaviors decreased and the skin condition improved. Follow-up at six month intervals for three years indicated no recurrence of skin problems.

Adult↗
PubMed1988

CT scanography for limb length determination.

The authors present an alternative to classic techniques used to measure limb length discrepancy radiographically. CT scanography seems to have advantages over currently-used Bell-Thompson roentgenography in that it uses less radiation and is of no increase in cost.

Adult↗