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Biomedical subjects

M Zielezny

Publications and source records attributed to M Zielezny.

At least 55 records · Page 3Linked to original sources

Assessing nutrient intake with an abbreviated dietary interview.

There is considerable interest in developing a means of assessing dietary intake of specific nutrients with minimal time and expense in epidemiologic studies. Using data from 1,682 individuals who were interviewed using an extensive food frequency dietary history, the authors examined the question of how many foods might be minimally required in order to estimate specific nutrient intakes for epidemiologic purposes. Nutrient indices were constructed for vitamins A and C, dietary fiber, fat, protein, and total calories based on 128 foods included in the interview. They found that a large fraction of the variability of nutrient intake in this population could be explained by a small number of foods. An abbreviated dietary history ascertaining the intake of as few as 15-20 food items may be all that is required in order to test the association between disease outcome and the intake of a single nutrient.

Age Factors↗

Lifetime occupational exercise and colon cancer.

The authors used data on patients aged 30-79 years admitted to the Roswell Park Memorial Institute in Buffalo, New York, 1957-1965, to compare the amount of lifetime occupational physical activity for 210 white male patients with cancer of the colon and 276 white male patients with cancer of the rectum to the lifetime occupational physical exercise of 1,431 patients with nonneoplastic nondigestive diseases. The authors found that risk of cancer of the colon increased with increasing amount and proportion of time in jobs involving only sedentary or light work. This relationship was not found for rectal cancer. These findings corroborate those of Garabrant et al. (Am J Epidemiol 1984; 119:1005-14). The strength of the associations presented here and the dose-response relationship indicate that limited physical activity could be an important etiologic factor. More inquiries need to be undertaken to study exercise in relation to other factors, such as diet, in colon cancer risk.

Adult↗

An inquiry into the epidemiology of melanoma.

The authors conducted a study of 404 melanoma patients and 521 control patients of both sexes at Roswell Park Memorial Institute. As have previous investigators, they found that higher risk attaches to upper socioeconomic status, as measured by occupation and education, lightness of complexion and hair, and amount of blue in the admixture of eye color. The authors also found a higher risk among individuals who reacted to sun exposure by burning, blistering, or freckling rather than by tanning. A particular concern was to measure risk associated with exposure to the sun. As have two other investigators, they found that risk decreased with increasing exposure, suggesting either that individuals continually exposed to the sun have less risk because of tanning, or that susceptibles purposely avoid sun exposure, or both. The fact that melanoma occurs with greater frequency on sites exposed to the sun suggests that sun exposure plays a part. These studies showed a dose-response increase in risk (odds ratios of up to 4 for males and over 6 for females) with increases in number of traits possessed, such as light complexion, and burning or freckling in response to sun exposure. This is consistent with the authors' earlier finding of a strong familial aggregation of melanoma.

Adult↗

The medical-psychiatric unit: a novel psychosomatic approach.

A retrospective chart review of 600 general hospital patients, of whom 200 had been admitted to a medical-psychiatric unit, 200 to a conventional psychiatric unit and 200 to medical-surgical units, and for whom psychiatric consultation had been requested, disclosed significant differences in the patient populations of these services. The data suggest that consultation psychiatry and medical-psychiatric units serve two different subgroups of patients with combined physical and psychiatric illness. A comprehensive model of clinical psychosomatic medicine encompassing consultation psychiatry, liaison psychiatry, medical-psychiatric units and after-care medical-psychiatric clinics, is proposed.

Adult↗

Uptake of technetium-99m methylene diphosphonate by fractured and osteoporotic bone after a pulse dose of vitamin D3.

The effect of a pulse dose of Vitamin D3 on uptake of [99mTc]MDP by fractured and osteoporotic bone, respectively, was compared with D3's effect on uptake by normal bone in rats. At 4, 7, and 14 days, respectively, after femoral fracture, basal uptake was significantly (p less than 0.005) increased at the fracture site by 336.8, 276.1, and 183.5%, respectively, over the contralateral control site. D3-treated rats had lower uptakes than untreated controls at all three fracture sites and at 12 of 15 normal bone sites but analysis of variance showed the uptake differences were not significant. Cortisone-induced osteoporosis caused a significant (p less than 0.05) decrease in basal uptake. The decrease occurred in all nine bone areas studied. D3 caused a significant (p less than 0.05) increase (mean 16.2%) in uptake by these osteoporotic bones, but a significant (0.1 greater than p greater than 0.05) decrease (mean 13.0%) in uptake by the same bones in normal controls. Thus, D3 had an effect on uptake by the bone lesion, osteoporosis, that differed from D3's effect on uptake by fracture or normal bone.

Animals↗

Treatment responses in primary and secondary melancholia: a preliminary report.

Ten patients suffering from primary affective illness and melancholia were compared to 10 melancholic subjects whose depression was chronologically superimposed on a preexisting nonaffective psychiatric disturbance. Both groups displayed a satisfactory response to treatment with amitriptyline. Similar patterns of improvement were reported in the two groups, and there was a concordance of subjective and objective rating methods.

Adult↗

Prolactin, amitriptyline, and recovery from depression.

Spontaneous prolactin patterns were determined at 15-min intervals over 5 h in 13 patients, who were suffering from melancholia, during illness and after treatment with amitriptyline. Plasma prolactin levels were significantly greater at most sampling points after patients had recovered than during their illnesses. One patient, who did not recover, showed the opposite trend.

Adult↗

Patterns of depression and illness behaviour in general hospital patients.

Little interest has been taken in the characteristics of depression in medical and surgical patients and its correlations with syndromes which may be subsumed under the rubric of abnormal illness behaviour. Depressive symptoms and abnormal illness behaviour as measured by self-rating scales were studied among 325 inpatients of a general hospital. A principal component analysis was carried out. A first factor reflecting general severity was characterized by depressed affect, somatic symptoms, retardation, hypochondriasis, and disease conviction and showed considerable stability within the group. A second factor suggested that in contrast to the younger patients, older patients had a tendency to focus on somatic problems and not psychological determinants, were likely to attribute all difficulties to physical illness, and lacked readiness to report interpersonal friction.

Age Factors↗

Psychological distress and amniocentesis.

40 women who underwent amniocentesis were administered the Symptom Questionnaire to evaluate changes in psychological distress. Anxiety, depression, somatic symptoms and hostility significantly decreased after the results of the procedure were communicated to the patient, replicating the findings in a previous study. Psychological distress, however, returned to the initial levels in the third trimester of pregnancy. Women whose only indication for amniocentesis was an age of 35 years or older displayed significantly higher hostility and somatic symptoms and less contentment before the procedure than the other women. Subsequently these differences lost their significance and the two groups showed similar patterns of psychological distress throughout the pregnancy.

Adult↗

Cost evaluation of a two-stage classification procedure.

A two-stage classification rule is suggested for classifying an individual into one of two multivariate normal populations. An individual may be classified using measurements on just the first subset; otherwise the second subset is measured and he is classified using the combined set. On the basis of misclassification costs and costs of collecting observations, the two-stage rule is compared with the usual rules based on the first subset and on the combined set. Comparisons are made for the case of known population parameters and also for the case of unknown population parameters which are estimated from samples. It is assumed throughout that a priori probabilities, cost of misclassification, and cost of making observation are known.

Classification↗

Factors moderating the effect of oral sulfonylureas on free water clearance.

The effects of the antidiuretic agent chlorpropamide and the diuretic agent tolazamide on solute-free water clearance (CH2O) were compared in noninsulin-dependent diabetic patients undergoing water diuresis. Hyperglycemia (fasting serum glucose above 200 mg/dl) obscured the effects of these two sulfonylureas on CH2O. Thiazide or ethacrynic acid enhancement of chlorpropamide antidiuresis was also blunted by hyperglycemia and attendant osmotic diuresis. Thus, the low incidence of symptomatic hyponatremia during chlorpropamide treatment of diabetic patients may be explained by persistent hyperglycemia in such patients.

Aged↗

Hypochondriacal fears and beliefs in DSM-III melancholia. Changes with amitriptyline.

The authors administered the Illness Attitude Scales, which identify hypochondriacal patients, to 20 nonpsychotic inpatients with DSM-III diagnosis of melancholia before and after 4 weeks of treatment with amitriptyline, and to a matched group of normals. Before treatment characteristic hypochondriacal responses occurred in over one-third of melancholics whereas after treatment the number was the same as in normals. The findings are in accord with the clinical observation that melancholia is one of the causes of hypochondriacal fears and beliefs and these tend to remit with recovery from depression.

Adult↗

Rating depression in normals and depressives: observer versus self-rating scales.

Different methods of assessing depression and anxiety were tested in 20 patients suffering from a major depressive disorder with melancholia and 20 matched control subjects. Depressives were assessed before and after treatment with amitriptyline and normals were retested at the same interval. The scales used were: Paykel's Clinical Interview for Depression--which is an expanded version of the Hamilton Depression Rating Scale; the Brief Depression Rating Scale; and Symptom Questionnaire (SQ). All scales discriminated sensitively between patients and normals and the scores changed substantially with treatment. Except for the well-being subscales of the SQ, the scales showed an adequate test-retest reliability in normals. Although all scales were suitable for the measurement of depression, they differed in psychometric properties. For example, the Depression subscale of the SQ showed an unusually high test-retest reliability in normals, whereas the Contentment subscale was unreliable. Yet, the latter has been found to be highly sensitive in detecting differences between the effects of psychotropic drugs and placebo in drug trials, so it appears to measure sensitively a fleeting mood. The combined use of all three scales in patients with affective disorders yields information that might not be revealed if only one scale is used.

Adult↗

Hypochondriacal fears and beliefs in agoraphobia.

In order to evaluate hypochondriacal fears and beliefs in agoraphobia, the authors administered the self-rated Illness Attitude Scales to 18 agoraphobic patients. The patients reported hypochondriacal concerns similar to those of patients with hypochondriasis. After agoraphobia had been treated with exposure therapy in ten patients, hypochondriacal concerns did not differ significantly from those of normals. The findings suggest that hypochondriacal concerns are substantial in agoraphobia and that these wane when anxiety decreases.

Adult↗

Drinking water, fluid intake, and bladder cancer in western New York.

Fluid intake and consumption of specific beverages were investigated in a study of 351 white male cases for whom transitional cell carcinoma of the bladder had been confirmed histologically during the time period from 1979 to 1985. A total of 855 white male controls was selected from Erie, Niagara, and Monroe counties of western New York state. Total fluid consumption was composed of alcoholic beverages, bottled beverages, soda, milk, coffee, tea, all juices, and glasses of tap water. Tap water included coffee, tea, juices, and glasses of water taken directly from the tap. Total fluid consumption was found to be a strong risk factor for bladder cancer when a number of potential confounding risk factors were controlled for. Risks were higher among those who were less than 65 y of age (odds ratio [OR] = 6.3, 95% C.I. = 2.8-14.0). The OR was 3.4 (95% C.I. = 1.8-6.2) for the highest quartile of fluid consumption among those 65 y of age and older. The tap water component was associated with increased risk in both age categories, and there was a clear dose-response relationship. Risks associated with tap water consumption were higher among those who never smoked cigarettes. Both biological and nonbiological explanations for these results are evaluated. The findings suggest implications for public health, but the limitations of the present investigation preclude definitive conclusions and stress the urgency for replication.

Adult↗