Biomedical subjects

O B Tofler

Publications and source records attributed to O B Tofler.

11 recordsLinked to original sources

PubMed2001

Coffee and coronary heart disease.

BACKGROUND: The role of coffee consumption in the onset of myocardial infarction remains uncertain. A review of published reports showed that although cohort data suggest very little excess risk of coronary heart disease among habitual coffee drinkers, case-control data suggest an excess risk of the order of 60% for people drinking five or more cups per day. METHODS: We obtained as much information as possible on the lifestyle and habits, including coffee consumption, of people admitted with chest pain to the Coronary Care Unit at the Royal Perth Hospital, Australia. A questionnaire was given to them by the attending nursing staff. Details were recorded by the patient, often with help from the nursing staff. A similar questionnaire was completed by patients attending the Cardiology Outpatient Clinic. RESULTS: One of the outstanding differences between the 182 patients with myocardial infarction or unstable angina and 185 patients with chronic stable coronary heart disease who filled in forms while waiting in the Cardiology Outpatient Clinic was that more people with acute coronary syndromes were drinking in excess of five cups of coffee per day (18 vs 7.5%; P = 0.003). In logistic regression analysis adjusted for age, smoking status (past and current), hypertension, dyslipidaemia and diabetes, the odds ratio was 2.51 (95% CI 1.43,4.43; P = 0.021). CONCLUSION: The present case-control study provides evidence for an increased risk of myocardial infarction or unstable angina among individuals drinking more than five cups of coffee per day.

Journal Article↗

PubMed1995

Quality of life.

Explore the source record for details and available documents.

Clinical Medicine↗

PubMed1990

Use of auscultation to follow patients with mitral systolic clicks and murmurs.

Mitral systolic clicks and murmurs together with associated symptoms constitute a major reason for cardiologic referral. Although echocardiography with Doppler study enables characterization of the mitral valve apparatus and quantification of regurgitation, its use has resulted in an overemphasis of the technical diagnosis of mitral valve prolapse and an undervaluation of diagnosis based on physical examination. To determine the clinical significance of an auscultatory classification of mitral systolic clicks with or without precordial systolic murmurs, 1 consultant's medical records of 291 patients with these signs were reviewed. Based on initial auscultatory findings, patients were divided into: (1) single or multiple apical systolic clicks with no murmur (n = 99); (2) single or multiple apical systolic clicks and a late systolic murmur (n = 129); and (3) single or multiple apical clicks and an apical pansystolic murmur or murmur beginning in the first half of systole (n = 63). The average duration of patient follow-up was 8 years (range 1 to 30). The prognosis was excellent for patients from all 3 classes. Two cardiac-related deaths occurred: 1 each from classes 1 and 2. Mitral valve surgery was performed in 3 class 2 patients (2%) and in 2 class 3 patients (3%). No patients developed endocarditis during follow-up. Palpitations, with varying anxiety overlay, constituted a major indication for cardiologic referral in all 3 classes. Auscultatory findings were valuable to the physician for explanation and relief of patient anxiety. For patient management, use of an auscultatory classification may be preferable to the technically generated term "mitral valve prolapse."

Adult↗

PubMed1981

A 13-year follow-up of social drinkers.

In 1965-66 we examined 359 men in the workforce reporting an alcohol consumption ranging from nil to the equivalent of 11.4 L of beer a day. We found an association between reported drinking and the prevalence of hypertension and gout. Thirteen years later, we were able to trace 340 of these men; 39 of them had died. Survival curves showed that the heavier drinkers (those drinking more than: 1.14 L of beer a day) tended to die at an earlier age. Due to the relatively small numbers involved, the difference in mortality between the lighter and heavier drinkers was not statistically significant. We found no support for the theory that alcohol consumption affords protection against death from coronary heart disease.

Actuarial Analysis↗

PubMed1981

Weight reduction in a normal population.

Weight loss of more than 2 kg under the guidance of a trained nurse was achieved over a 12-month period in 38% of overweight hospital and transport workers. Males over 50 were the subgroup most successful in losing weight. Weight loss achieved by older males with an "off-hand" as compared with an "energetic" approach was similar up until nine months, after which the "energetic" approach was more effective. Females on an "energetic" diet were successful up until nine months only. The "off-hand" approach is acceptable to more people and is less time-consuming. It should therefore be seriously considered by a public health authority which seeks to promote weight reduction in the general community.

Adult↗

PubMed1979