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Biomedical subjects

R G Hoffmann

Publications and source records attributed to R G Hoffmann.

At least 127 records · Page 7Linked to original sources

Alcohol consumption and ischemic heart disease mortality: are time-series correlations meaningful?

Recently, time-series correlations of aggregated data have been used to demonstrate the length of latency periods for environmental factors, such as economic conditions and alcohol consumption, in influencing heart disease mortality. Latency periods were specified by lagging mortality rates relative to the economic indicators or rates of alcohol consumption until the highest correlations were achieved. The tendency has been to interpret these correlations without regard to whether the latency periods described are biologically plausible. The authors have identified four models which represent all the possible outcomes of correlational studies of time-series data. Using United States and Canadian mortality rates in relationship to alcohol consumption, they have demonstrated the application of each of these models. For three of the four models, the time-series (lag) correlations are uniform regardless of the number of years mortality is lagged relative to alcohol consumption, and this uniformity does not permit a latency period to be identified. Only the lag correlations between two nonlinear variables show variations over time, depending on the degree of correspondence between the increasing and decreasing line segments of the two curves. Correlations ranging from high positive to high negative are possible, and several peak correlations (positive and negative) can occur. However, the biologic interpretation of multiple peaks with the same or different signs is problematic. The authors conclude that time-series correlations of aggregated data are not useful for the study of latency periods, and that analysis of time-series correlations for this purpose can be at best ambiguous, and at worst, completely misleading.

Adolescent↗

Prostaglandin-mediated effects on growth and markers of biochemical development in the rat.

Several markers of growth and biochemical development in the rat were studied after administration of prostacyclin (PGI2) and 16, 16-dimethyl prostaglandin E2 (16, 16DM PGE2). Intermittent administration of PGI2 for 3 days to 10- and 19-day-old animals, with subsequent sacrifice at 14 and 23 days, resulted in significant dose related decreases in growth at 23 days. Total sucrase and maltase (glucoamylase) activities were elevated compared to controls at 14 days. Total activities of these enzymes were decreased in postweaned 23-day-old animals, but specific activities per mg intestinal protein were not significantly different. 16, 16DM PGE2 administered continuously between day 10-16 of life caused alterations in growth as well as increases in sucrase and maltase (glucoamylase) activities. Exogenously administered prostaglandins, therefore, are associated with altered growth and markers of biochemical development in the rat.

16,16-Dimethylprostaglandin E2↗

Relationship of androgenic activity to body fat topography, fat cell morphology, and metabolic aberrations in premenopausal women.

A possible role for increased androgenic/estrogenic activity in the pathogenesis of upper body fat localization and its accompanying cellular and metabolic characteristics was examined. Eighty healthy, nonhirsute, premenopausal, caucasian women with a wide range of body fat topography [waist to hips girth ratio (WHR), 0.64 to 1.02] and obesity level (percentage of ideal body weight, 92-251%) were studied. Increasing androgenicity, as reflected by a decrease in plasma sex hormone-binding globulin capacity and an increase in the percentage of free testosterone, was accompanied by 1) increasing WHR, this relationship being independent of and additive to that of obesity level; 2) increasing size of abdominal, but not femoral, adipocytes; 3) increasing plasma glucose and insulin levels, both basally and in response to oral glucose loading; and 4) diminished in vivo insulin sensitivity, as revealed by increasing steady state plasma glucose levels at comparable plasma insulin levels, attained by the infusion of somatostatin, insulin, and glucose. No association was found between total plasma testosterone, androstenedione, dehydroepiandrosterone sulfate, or estradiol concentrations and WHR, fat cell size, or metabolic profiles. We, therefore, propose that in premenopausal women, a relative increase in tissue exposure to unbound androgens may be responsible in part for localization of fat in the upper body, enlargement of abdominal adipocytes, and the accompanying imbalance in glucose-insulin homeostasis.

Adipose Tissue↗

Antithoracic duct lymphocyte globulin therapy of severe aplastic anemia.

We performed a prospective randomized trial of antithoracic duct lymphocyte globulin (ATDLG), HLA-haploidentical marrow, and androgen (regimen ABA) versus androgen alone (concurrent STANDARD care controls) in 42 newly diagnosed individuals with severe aplastic anemia. ABA patients also were matched with patients from our preceding study (historical STANDARD care controls). Supportive care and pretreatment patient characteristics were the same in all groups. By life table analysis, 76% of patients receiving ABA are alive at 2 yr compared to 31% of the concurrent control group (p less than 0.002 versus ABA) and 19% of the historical controls (p less than 0.0001 versus ABA) given STANDARD care. ABA patients had greater hematologic improvement than either control group (p less than 0.001). However, improvement with ABA was often incomplete. Toxicity of ATDLG was considerable but manageable. Further studies to determine the mechanism of action and active component(s) of ABA are indicated.

Androgens↗

Death of a child at home or in the hospital: subsequent psychological adjustment of the family.

Twenty-four families who had participated in a Home Care Program for children terminally ill with cancer and 13 families of similar children who had died in the hospital completed inventories on parent and sibling personality as well as family functioning three to 29 months after the child's death. Parents of patients who received terminal care in the hospital were more anxious, depressed, and defensive and had greater tendencies toward somatic and interpersonal problems than parents of patients in the Home Care Program. Siblings of patients who received terminal care in the hospital were more emotionally inhibited, withdrawn, and fearful than their counterparts in the Home Care Program. Although some group differences in parental personality may have antedated terminal care, these results confirm parental reports of more adequate family adjustment following participation in a structured Home Care Program.

Adaptation, Psychological↗

Smoking, alcohol and coronary artery occlusion.

The effects of smoking and alcohol intake on the extent of coronary artery occlusion were studied in 2989 men undergoing a diagnostic coronary arteriography. Smoking showed an exposure-related enhancing effect on the extent of coronary artery occlusion. Conversely, alcohol consumption demonstrated an attenuating dose-related effect, offsetting the increased coronary occlusion associated with smoking. Alcohol intake should be considered in studies evaluating the risk factors--coronary artery disease interaction.

Alcohol Drinking↗

Effects of drinking patterns on the relationship between alcohol an coronary occlusion.

Previous reports have described an inverse relationship between alcohol consumption and the prevalence of myocardial infarction or the extent of coronary artery occlusion. The study reported here explored the relationship between patterns of alcohol intake and coronary occlusion in 526 patients who have had coronary arteriography. Patients were characterized as regular drinkers, occasional drinkers and non-drinkers. Regular drinkers were further characterized as drinking relatively consistent amounts or variable amounts. The inverse correlation between amounts of alcohol consumed and coronary occlusion found in previous studies was reaffirmed. It was also observed that the pattern of alcohol intake was related to the degree of occlusion. Higher levels of occlusion were found among non-drinkers, occasional drinkers, and regular drinkers with patterns of variable intake, while significantly lower levels of occlusion were observed for regular drinkers who drank relatively consistent amounts (P = 0.014). Furthermore, while occlusion scores were inversely correlated with amounts consumed by regular drinkers with consistent intake (P = 0.019), drinkers with variable drinking patterns had higher occlusion scores regardless of amounts consumed. Analyses of serum lipids according to drinking patterns showed a significant association between the total/HDL cholesterol ratio and drinking patterns. These findings suggest that whatever attenuating effect alcohol consumption might exert on coronary occlusion, it appears to be reversed by a variable or sporadic pattern of alcohol intake.

Adult↗

Blood pressure and alcohol intake in heart patients.

The association between alcohol consumption and blood pressure has been studied in 2025 male and 282 female patients undergoing diagnostic coronary angiography. The increase in amount of alcohol consumed correlated with higher systolic and diastolic blood pressure; this effect was especially pronounced in men over 50 years of age. The association was less marked in male patients under 50 years old, in women, and in patients on antihypertensive medication. Readings in the range of definitive hypertension were more prevalent among older patients consuming six or more drinks daily than in abstainers of the same age group.

Adult↗

Allergic bronchopulmonary aspergillosis in corticosteroid-dependent asthmatics.

Forty-two corticosteroid-dependent asthmatics were studied to determine whether their underlying disease might be allergic bronchopulmonary aspergillosis (ABPA). The clinical and laboratory characteristics studied included age, sex, atopic status, mean corticosteroid doses, skin tests to Aspergillus fumigatus (Af), precipitins to Af, total serum IgE, and chest roentgenograms. Twelve patients had four or more of the seven primary criteria used and were considered as the ABPA suspect group. Further studies identified three patients who were considered to have definite ABPA and an additional three patients with probable ABPA. This study suggests that previously undiagnosed ABPA can be detected in populations of corticosteroid dependent asthmatics. Corticosteroid therapy may mask ABPA, and serial evaluations of these patients may be of value in detecting additional cases of the disease.

Adolescent↗

Precipitating antibodies to farmer's lung antigens in a Wisconsin farming population.

The prevalence of farmer's lung disease and antibodies to farmer's lung antigens were studied in a probability sample of over 1,400 farmers in north central Wisconsin. The prevalence rate of farmer's lung disease was 4.2 per 1,000 farmers. The most prevalent antibody type was directed against Micropolyspora faeni, with 6% of the study population precipitin-positive. Prevalence of antibodies to M. faeni was associated with dairy farming, larger farms, and larger dairy herds. An additive effect of hay acreage and size of dairy herd was observed. An independent relationship was also observed for cigarette smoking, with antibodies to M. faeni more prevalent among nonsmokers.

Adolescent↗

The probability of surviving coronary bypass surgery. Five-year results from 1,718 patients.

This study of 1,718 men with bypass surgery from 1970 to 1974 in Milwaukee has indicated that the following factors are significantly associated with five-year survival: left ventricular end-diastolic pressure (LVEDP), plasma cholesterol level, coronary occlusion score, age, and left ventricular function (LVF). The 31 men with a previous stroke had a high risk (five-year survival was 32%). To serve as a guide to patient risk, a logistic model is used to predict five-year survival. These probabilities are tabulated for all combinations of LVEDP, age, LVF, occlusion score, and plasma cholesterol level.

Adult↗

Retention or resumption of employment after aortocoronary bypass operations.

Employment status and factors related to resumption of employment were studied in 564 male patients one and four years following an aortocoronary bypass operation. For age categories of less than 55, 55 to 59, and 60 years or older at the time of the operation, 90%, 68%, and 44%, respectively, remained employed four years later. Age at the time of the operation, development of angina pectoris after the operation, a previous myocardial infarction, and the physical requirements of the patient's employment were found to be related to the decision not to work four years after the operation. Of patients not employed prior to the operation, 22% were employed four years later.

Age Factors↗

An assessment of cardiorespiratory adjustments of asthmatic adults to exercise.

The cardiorespiratory adjustments of asthmatic adults to submaximal and maximal workloads were investigated. Cardiorespiratory variables were measured every 2 min during exercise and at the end of maximal physical effort. Exercise-induced asthma (EIA) occurred in all asthmatic subjects while normal subjects maintained normal spirometry. The results suggest that asthmatic adults have no cardiac reserve or oxygen delivery limitations. They work under less efficient ventilatory conditions at submaximal workloads and have a significantly lower functional work capacity. The high degree of correlation between preexercise maximal midexpiratory flow rate (MMF) and maximum O2 consumption (max Vo2) suggests that the smaller airways contribute significantly to the observed abnormalities. We recommend that evaluation of antiasthmatic medications in exercise-induced asthma should take into consideration their effect upon smaller airways and cardiorespiratory variables.

Adult↗

Interrelationship between coronary artery occlusion, high-density lipoprotein cholesterol, and alcohol intake.

The interrelationships between coronary artery occlusion, alcohol consumption, and plasma levels of HDL cholesterol were investigated in 718 male patients undergoing coronary arteriography. A statistically significant inverse relationship was seen between the extent of coronary occlusion and alcohol intake and between coronary occlusion and plasma HDL cholesterol levels. A positive association was observed between the amounts of alcohol consumed and plasma HDL cholesterol levels, as well as between alcohol consumption and history of smoking. The findings of the present study suggest that the "retarding" effect of alcohol on coronary artery disease may be at least partially explained by the alcohol-induced rise of plasma HDL cholesterol.

Alcohol Drinking↗